Diagnosis

It is not always easy to know if a person has had a seizure, and information from tests alone cannot confirm that a seizure has occurred. In some people, all the tests are normal, but - based on their history - the doctor is certain the person has had a seizure. A variety of methods may be used to diagnose the cause of seizures:

* Medical history

This is whereby one goes to a doctor for diagnosis of epilepsy. The doctor will give you time to narrate the events preceding the seizure and even what happened after. It is always advisable to go with someone who has seen the seizure so that they could describe exactly what happened during the seizure, how long it took and how long it took for you to recover and in general your behaviour. There are some people who do not lose consciousness and in such cases, one can go alone to the doctor and describe what happened. Most of the time, a doctor is able to diagnose epilepsy after the medical history without using further technology. Below is a sample of questions the doctor might ask:

Before the seizure:

* Did you experience lack of sleep or unsual stress?

* Were you sick recently?

* Did you take any kind of medication, including over-the-counter medicines, alcohol or illegal drugs?

* What were you doing immediately before the event e.g. lying down, sitting, standing, getting up from a lying position or doing heavy exercise e.t.c.?

During the Seizure:

*What time of day was it?

* Were you just waking up or falling asleep?

* How did it begin?

* Was there a warning sign?

* Did your eyes, mouth, face, head, arms or legs move abnormally?

* Were you able to talk and respond appropriately?

* Did you lose control of your baldder or bowels?

* Did you bite your tongue or the inside of your cheeks?

After the seizure:

* Were you confused or tired?

* Could you speak normally?

* Did you have a headache?

* Did your muscles ache?

If the doctor would like to do some research on the particular cause of the seizures, they can make use of the several methods to perform medical examination. The most commonly used methods for diagnosis are the EEG and the MRI.

* Electroencephalogram (EEG)

The EEG records and measures the electrical activity of the brain. Special sensors are attached to the head and hooked by wires to a computer. The computer records the brain's electrical activity on the screen or on paper as wavy lines. A seizure can be seen by the changes in the normal pattern of the brain's electrical activity. The EEG is the most useful and important test in confirming a diagnosis of epilepsy. During an EEG, an EEG technologist will attach electrodes to the scalp which they remove again when the test is over. The person may be asked to herperventilate to try to activate brain discharge during part of the study if this is safe medically and flashing lights will be used similarly during the test. Most EEGs can be run in about an hour or less and results are generally avaiolable to your physician within one week.

* Magnetic resonance imaging (MRI)

An MRI uses a magnetic field to take pictures of the inside of your body and offers a doctor the best chance of finding out the source of the seizures as epilepsy can be caused from a scar tisue in the brain and an MRI can show scar tissue and allow doctors to determine its nature. The images produced from the MRI are extremely precise. The information provided by the MRI is valuable in the diagnosis and treatment of individuals with epilepsy and to determine whether surgery would be beneficial. Before the actual test, the person will be asked to lie down on a narrow bed. Once the person is comfortable, the technician will gently push the bed inside a shaped tube. It is important to lie as still as possible during the test. The technician will guide the person through each step. The MRI test is painless though sometimes it is necessary to get an injection known as a 'contrast' before the test. It is ususally a minor discomfort - a quick prick that does not take too long. Once in the tube, the person will hear a series of knocking sounds. It is however important to lie quietly if one hears these sounds as it is the machine making the images.