How to Diagnose a Seizure
Seizures are defined as unexpected electrical signals in the brain that cause changes in behavior, sensation, and/or consciousness.In order to diagnose a seizure, you need to recognize seizure symptoms, work with a health care professional, and identify possible causes and risk factors. If you or someone you love experiences a seizure for the first time, it is important to contact emergency services.
Recognizing a Seizure
Notice a blank stare.When most people think about seizures, they imagine a person convulsing. However, seizures can look different for different people. One manifestation of a seizure simply looks like a blank stare that can last anywhere from a few seconds to a few minutes. The individual may appear to look right through you. They may or may not blink.
- This is often, but not always, accompanied by a loss of awareness.
- Seizures accompanied by blank stares are usually absence seizures, which are common in children. In many cases, these seizures don't cause long-term problems.
Observe body stiffening.Another symptom of seizure activity manifests as the inability to move parts of the body and/or extreme stiffening of the body. This most commonly occurs in the limbs, jaw, or face. This is sometimes accompanied by a loss of bladder control.
Watch for a sudden loss of muscle strength.Atonic seizures involve sudden loss of muscle strength, which can cause the person to fall to the ground. The person's muscles will go limp, causing a sudden drop. These seizures usually last less than 15 seconds.
- The person usually remains conscious during the seizure.
- A person with atonic seizures may not always fall down. The drop could affect just the head, just the eyelids, or just one part of the body.
Notice a loss of awareness or consciousness.Seizure activity may cause a person to blank out and lose anywhere from a few moments to a few minutes of awareness. In some cases, a seizure may even cause the person to pass out and lose consciousness completely.
- If a person does not revive within a matter of a few minutes, seek emergency medical attention.
- Loss of consciousness may last 10-20 seconds, followed by muscle convulsions that usually last for under 2 minutes. This is usually caused by a grand mal seizure.
Recognize jerking movements or shaking of the arms and legs.The most recognizable seizure symptom is shaking, jerking, and convulsing. This can range from very mild and hardly perceptible, to quite violent and severe.
Record the symptoms.When you or someone with you experiences seizure-like symptoms, it is important to write all them down, including their duration. Since doctors are not usually present at the time of a seizure, it can make seizures difficult to diagnose. The more information you can provide a doctor, the better they can help determine the type of seizure that has been experienced, and the possible cause.
Seek medical attention.If you or someone with you experiences seizure-like symptoms for the first time, call a doctor and possibly visit the emergency room. If the person has already been diagnosed with epilepsy, medical care may not always be necessary.Seek immediate medical care if:
- A seizure lasts longer than 5 minutes.
- A second seizure occurs immediately.
- You have trouble breathing after the seizure stops.
- You are unconscious after the seizure.
- You have a fever over 103 °F (39 °C).
- You are pregnant, or recently had a baby.
- You have been diagnosed with diabetes.
- You have sustained an injury during the seizure.
Working with a Doctor
Maintain a detailed seizure log.Every time you (or someone with you) has a seizure it is important to write down what happened. Often a doctor will request the patient to keep a seizure log prior to any examination. Always include the date and time of any seizure, as well as how long it lasted, what it looked like, and anything that could have triggered it (such as lack of sleep, stress, or injury).
- If you are the one who experienced the seizure, ask for input from people who witnessed it.
Schedule an appointment with your doctor.When you or someone you love experiences an unexplained symptoms, it is important for them to visit a doctor. Bring along as much information as possible to help give the doctor a clear picture of the seizure activity.Prepare for a doctor’s appointment by:
- Finding out about any pre-appointment restrictions, and following these restrictions. (The doctor may ask the patient to alter your diet or sleep pattern.)
- Recording any recent life changes or sources of stress.
- Writing down any medications the patient is taking, including vitamins.
- Making arrangements for a family member or friend along to the appointment.
- Writing down any questions for the doctor.
Request a medical evaluation.In order to determine the cause of the seizure, the doctor will listen carefully to all of the symptoms and do a basic physical examination. Additionally, the doctor will evaluate the patient for physical and neurological conditions that can lead to seizure activity.The evaluation is likely to include:
- Blood tests - These will be used to check for signs of infections, genetic conditions, or other health conditions that could be associated with a risk of seizure.
- A neurological exam - This can help the doctor diagnose the condition and possibly determine the type of epilepsy present. This can include tests of behavior, motor abilities, and mental function.
Request more advanced tests to detect brain abnormalities.Based on the symptoms present, any previous medical history, the results of any blood tests, and any findings from the neurological exam, the doctor may order a series of tests.Tests used to detect brain abnormalities can include:
- Electroencephalogram (EEG)
- High-density EEG
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Functional MRI (fMRI)
- Positron emission tomography (PET)
- Single-photon emission computerized tomography (SPECT)
- Neuropsychological tests
- Complete Blood Count (CBC) test to eliminate infection, anemia, glucose fluctuations, or thrombocytopenia
- Blood Urea Nitrogen (BUN) or creatine test to exclude electrolyte disturbances, hypoglycemia, or uremia
- Drug and alcohol screening
Work with a doctor to pinpoint where seizures originate in the brain.Determining the location of the electrical discharges in the brain can help the doctor understand the cause of certain seizures. Neurological analysis techniques are often done in conjunction with other neurological tests, such as MRIs and EEGs.Some neurological analysis techniques include:
- Statistical parametric mapping (SPM)
- Curry analysis
- Magnetoencephalography (MEG)
Understanding Possible Causes and Risk Factors
Test for infectious diseases.Certain diseases--such as meningitis, AIDS, or viral encephalitis--have been linked to increased risk of epilepsy. If the patient has already been diagnosed with 1 of these conditions, it could be the cause. It may be a good idea to test for these diseases.
Recognize connections to developmental disorders.Certain disorders, such as autism or neurofibromatosis, have been linked to increased risk of seizure activity. In some cases, these development conditions may go undiagnosed until seizure activity presents itself.
Talk to your doctor about medications, supplements, and intoxicants.Medications, herbal supplements, drugs, and alcohol can all be linked to seizures. Prescription medications and herbal supplements can lower your seizure threshold, so talk to your doctor and pharmacist before taking or mixing them. Similarly, withdrawal from drugs or alcohol can also make you prone to seizures.
- If you need to withdraw from a medication, drug, or alcohol, it's best to do so under the guidance of a physician.
Accept that there may be no cause.For about 50% of the people with epilepsy, there is no known cause. Identifying a root cause can help a doctor to treat certain forms of epilepsy, but in around half of epilepsy cases this will not be the case. There are still numerous treatments available to patients who have no identifiable cause.
Recognize additional risk factors for seizures.There are some health conditions and other factors that have been correlated with an increased risk for seizures. Although these conditions do not cause seizures, the presence of these risk factors may make seizures more likely.
Video: Signs and symptoms of a seizure: Epilepsy Center at Children's Hospital of Wisconsin
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