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Understanding Seizures -- Diagnosis and Treatment

How Do I Know If I Have Seizures?

To diagnose an apparent first-time seizure, your doctor will:

  • Take a detailed medical history (including a family history of seizures).
  • Gather information about your behavior before, during, and after the episode. It is very important to have someone with you who witnessed the episode and can describe it to the doctor.
  • Do a physical exam

These are tests that may be done:

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Understanding Temporal Lobe Seizure -- Diagnosis and Treatment

If someone has a seizure for the first time, if a seizure lasts longer than two to three minutes, or if multiple seizures occur one after the other, take him or her to the emergency room or call 911 immediately. If a seizure disorder is suspected, the doctor will begin by taking a thorough medical history, including any birth trauma, serious head injury, or infections of the brain, such as encephalitis or meningitis. Brain function can be "viewed" with an electroencephalogram, or EEG, which detects...

Read the Understanding Temporal Lobe Seizure -- Diagnosis and Treatment article > >

  • An electroencephalogram (EEG) to identify any abnormal electrical misfiring in the brain and help predict the risk of future seizures
  • Brain imaging tests such as an MRI or CT scan to help narrow down a possible treatable cause
  • A spinal tap if an infectious cause, such as meningitis, is suspected

 

What Are the Treatments for Seizures?

When a specific cause of the seizure is identified -- such as infection or low blood sugar -- treatment of that underlying condition often prevents seizures from recurring. If the underlying cause is not fully treatable or is unknown, treatment with anti-seizure (anticonvulsant) medications may be recommended.

Medications for Epilepsy

Anticonvulsant drugs can eliminate or reduce recurrent seizures. The choice of medication is based on the specific seizure type and pattern. Often, a single drug is used, but sometimes a combination may be necessary. Anticonvulsant drugs include:

  • Eslicarbazepine acetate (Aptiom)
  • Carbamazepine (Tegretol)
  • Divalproex sodium (Depakote)
  • Fycompa (Perampanel)
  • Gabapentin (Neurontin)
  • Lacosamide (Vimpat)
  • Lamotrigine (Lamictal)
  • Levetiracetam (Keppra)
  • Oxcarbazepine (Trileptal)
  • Oxteller XR (oxcarbazepine)
  • Phenobarbital
  • Phenytoin (Dilantin)
  • Pregabalin (Lyrica)
  • Primidone (Mysoline)
  • Tiagabine (Gabitril)
  • Topiramate (Topamax)
  • Valproic acid (Depakene)
  • Vigabatrin (Sabril)
  • Zonisamide (Zonegran) 

For some drugs, your doctor may test your blood to make sure you are taking the right amount of medication. Blood tests can also make sure drugs are not affecting your kidneys or liver. Some people may be able to stop taking medication once their seizures have been under control for at least a year.

Surgery and Other Procedures for Seizures

Doctors may suggest surgery for the few patients whose seizures can't be controlled with medications. In vagus nerve stimulation, a device that electronically stimulates the vagus nerve (which controls activity between the brain and major internal organs) is implanted under the skin in the neck. This reduces seizure activity in some patients with partial seizures. 

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