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Diagnosing Epilepsy
Evaluation and Medical History
When patients are referred to Hoag Epilepsy Center, evaluations begin with a thorough exam and medical history, followed by a complete diagnostic workup.
During the exam, patients may be asked the following questions related to their seizure:
Before the Spell
- Did you experience lack of sleep or unusual stress?
- Were you sick recently?
- Did you take any kind of medication, including over-the-counter medicines, alcohol, or illegal drugs?
- hat were you doing immediately before the event (for instance, lying down, sitting, standing, getting up from a lying position or heavy exercise)?
- How did it begin? (Jerking, abrupt fall, gradual "fade out", staring, etc.)
- Was there a warning? (Unusual feeling in the head, stomach, throat; tingling in part of the body; hearing or seeing unusual or distorted sounds or images; a feeling of strangeness; a feeling of familiarity.)
- What happened during? (Lip smacking, chewing; garbled speech; head turning; focal jerking, and abnormal body movements.)
During the Spell
- What time of day was it?
- Were you just waking up or falling asleep?
- How did it begin?
- Was there a warning?
- 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 bladder or bowels?
- Did you bite your tongue or the inside of your cheeks?
After the Spell
- Were you confused or tired?
- Could you speak normally?
- Did you have a headache?
- Did your muscles ache?
Specific questions about a patient’s medical history may include
- Was your birth difficult?
- Did you have any seizures with high fevers when you were a baby or small child?
- Did you ever have a head injury? If so, did you lose consciousness after the injury? How long were you unconscious? Were you taken to a hospital?
- Did you ever have meningitis (an infection of the membranes around the brain and spinal cord) or encephalitis (a serious viral infection of the brain)?
- Has anyone else in the family had epilepsy, any other neurological disorder, or a disorder associated with loss of consciousness?
Diagnostic testing
Armed with the most sophisticated diagnostic technology and imaging techniques, Hoag’s epilepsy specialists can accurately identify a patient’s specific type of seizure and the region of the brain where the seizures originate. These diagnostic technologies include: computed tomography (CT), computerized EEG with seizure detection, video EEG monitoring with 24-hour surveillance of seizure activity by video cameras, high resolution MRI, MR spectroscopy, functional MR (fMR), and positron emission tomography (PET).
And when in-depth study of a patient’s seizures is required, Hoag’s Epilepsy Monitoring Unit is equipped with the latest technology and a highly trained staff of physicians, nurses and technicians who evaluate the patient’s seizures over time. During the hospital stay, the patient is under constant visual observation while electrical activity of the brain, other physiological changes and video monitoring
of the body’s movements during seizures are recorded. Once the cause of a patient’s epilepsy is determined, treatment can be tailored to manage and control seizures.
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