Diagnosis of Epilepsy and Seizures
Patients should be evaluated thoroughly after their first seizure. It is imperative that the physician obtains a complete patient history, including details of birth, childhood, family history, and medication regimen; a thorough medical history, including illnesses of the nervous system; and a thorough history of drug and alcohol use.
A detailed description of the seizures is important to distinguish seizure types. Significant information includes the following:
- Events that occurred during the seizure
- Nature of the onset of the seizure
- Presence of triggers (e.g., flickering light, sleep deprivation, dehydration)
- Time of day of the seizure
- Whether the seizure occurred during wakefulness or sleep
- Whether awareness returns immediately or there is a prolonged period of confusion
Thorough physical and neurological examinations also are performed. Laboratory studies of blood and urine help identify liver and kidney dysfunction, which may (1) augment adverse effects of antiepileptic drugs and (2) rule out or identify certain underlying causes. These results also establish a baseline for monitoring kidney and liver function while the patient is on antepileptic medication. The kidney and liver metabolize most of these medications.