How Is Epilepsy Diagnosed?

Epilepsy is among the common conditions that affect the brain. In the United States, approximately, 5.1 million people including both children and adults have a history of epilepsy and approximately 2.9 million are still suffering for it. It is difficult to quickly diagnose epilepsy. In majority of the cases, the confirmed diagnosis cannot be made until more than one seizure is present. Many other conditions such as panic attacks and migraines may cause similar symptoms as epilepsy. A person having a seizure is referred to a neurologist to aid in diagnosis.

How Is Epilepsy Diagnosed?

The aim of diagnosing epilepsy is to determine the type of seizures and the cause behind them. The diagnosing methods are as follows:

1. Medical History

The diagnosis of seizures depends on the medical history of the patients along with any family history of seizures, current medicines and associated medical ailments. The descriptions of persons who have seen the patient having seizures are also helpful in the diagnosis of epilepsy, especially if the patient has lost consciousness. Some of the important questions that the doctor would ask the patient may include:

  • What was your age at the onset of seizures?
  • Under what circumstances, did the first seizure occur?
  • What factors are linked to the occurrence of seizures?
  • What do you feel before, during and after a seizure?
  • What is the duration of a seizure?
  • Have you undergone treatment of epilepsy before?
  • What medicines were prescribed previously and in what doses?
  • Are the medicines effective in treating the seizures?

2. Neurological Exam

Tests of brain functions are often included in the diagnosis of epilepsy. A neurological exam is used to detect abnormalities or problems in brain. The following are often included in a neurological exam:

  • A memory test to find out the person's ability of remembering words;
  • A test to measure the ability of naming and recalling certain objects;
  • Simple calculations and math;
  • Muscle function test by walking a couple of steps;
  • Tests of reflexes;
  • Sensory tests to detect which senses have been adversely affected by epilepsy.

Neurological exam can aid in determining if the brain has been damaged. For example, if a patient has trouble in recalling words, names or objects or has difficulty in figuring out the day or month during a test. A noticeable difference in gait when walking or weakness on one side or a part of the body may indicate problems with brain like epilepsy that needs medical attention.

3. Blood Test

A number of blood tests are recommended to find answer to the question "How is epilepsy diagnosed?"

Types of Blood Tests

  • Your physician may order a complete blood count or CBC. Under the CBC the following are measured: red blood cell count, white blood cell count, platelet count, hemoglobin, hematocrit and mean corpuscular volume.
  • Chemistry panel is another important blood test. Under this panel sodium, blood sugar and potassium levels are evaluated. A complete metabolic panel includes liver and kidney function tests.
  • Various other tests may be ordered including blood levels of medicines you are taking to control seizures.

Function of Blood Test:

  • Your physician can assess how your overall health is;
  • Identify ailments such as anemia, infections or diabetes that may be the cause of seizures;
  • Identify conditions affecting liver or kidney;
  • Monitor the occurrence of possible side effect of medicines.

4. The Spinal Tap

Spinal tap, also referred to as lumbar puncture, is also a test to diagnose epilepsy. The spinal tap helps in ruling out infections including encephalitis or meningitis as the cause of seizures.

How to Do

You will be asked to lie down on your side, the knees drawn close to the chest and the chin. Your back is cleaned with an antiseptic and a local anesthetic injected. Once the area is numb, a needle is inserted between 2 lumbar vertebrae. Once the spinal canal is penetrated, spinal fluid is collected. Then the needle is removed and the area covered with sterile bandage.

5. EEG Test

How is epilepsy diagnosed? Use EEG, which is one of the most common tests to diagnose epilepsy. This test requires attachment of electrodes to a person’s scalp with a pasty substance. The electrical activity of the brain is recorded by the electrodes. In epilepsy, the normal pattern of brain waves is changed.

6. CT Scan

During a CT scan, X-rays are used to produce cross-sectional images of the brain. It is used to diagnose the abnormalities in the brain that may be causing seizures including bleeding, tumors and cysts.

7. MRI

During an MRI, radio waves and powerful magnets are used to obtain a detailed view of the brain. The abnormalities of the brain that may be leading to seizures can be detected during an MRI.


During a functional MRI, the changes in the flow of blood in specific parts of brain that are working are monitored. FMRI is often used before surgery for the identification of the exact location of critical functions so as to avoid injuring these regions during surgery.


The last answer to "How is epilepsy diagnosed?" is SPECT. Single photon emission computed tomography or SPECT is used when the exact cause of seizures is not identified with an EEG and MRI. During the test a small amount of radioactive material is injected into a vein and a detailed 3D view of the brain is created during seizures.

If you are diagnosed with epilepsy, get a general idea about how to treat epilepsy from the video below: 

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