Seizures

Diagnosis

To determine what is causing your seizures, your doctor will start with a careful medical history. Because there are so many seizure disorders, medical history is essential for diagnosis. Clues such as the age at which seizures started and whether you have a family history of seizures will help your doctor pinpoint your syndrome. If someone you know has witnessed one of your seizures, it is a good idea to bring that person along so he or she can describe the seizure to your doctor.

Your doctor may order an electroencephalogram (EEG) to record the electrical activity of your brain and help determine what kind of seizures you have [Figure 1]. During an electroencephalogram, or EEG, your doctor will attach electrodes to your head to measure the electrical activity of your brain. The procedure takes about 20 minutes, and is painless. He or she will expose you to different stimuli (such as a strobe light) in an attempt to provoke seizure-like brain wave abnormalities. A series of EEGs may be needed to offer a complete picture of your brain's electrical patterns. Your doctor may use simultaneous video/EEG monitoring to capture a seizure in progress.

Brain imaging studies can isolate the area of your brain that is causing your seizures.

Both computed tomography (CT) and magnetic resonance imaging (MRI) reveal structural information about the brain that can be useful in locating tumors, cancer, previous strokes, and brain lesions although MRI generally gives a more detailed picture. Other types of brain scans, such as positron emission tomography (PET) and single photon emission computed tomography (SPECT), may further aid your doctor in isolating the source of your seizures.

Your doctor may order basic tests such as blood work, urinalysis, and an electrocardiogram to weed out any non-neurological problems that may be causing your seizures. In some cases, an overnight sleep study will reveal a sleep disorder to be the underlying cause. Likewise, a psychiatric evaluation can expose a psychological problem that may be contributing. A person with new-onset seizures and a fever may undergo a spinal tap to rule out an infectious cause of the seizures.

Figure 1. Electroencephalogram (EEG) of Seizure Activity

EEGs show the electrical activity of your brain. This electroencephalogram shows a juvenile myoclonic seizure, as evidenced by the area of activity in the center of the figure.

Prevention and Screening

Wearing a helmet while riding a bike or motorcycle, or while doing anything where you might fall and injure your head, can prevent a head injury that could lead to a seizure disorder. If you have a seizure disorder, taking your prescribed medication in the correct doses can help prevent seizures from coming on. Avoiding heavy alcohol use can prevent alcohol-withdrawal seizures.