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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, and do a physical examination. An electroencephalogram (EEG) may be done 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 may help to narrow down a possible treatable cause. A spinal tap may be recommended if an infectious cause, such as meningitis, is suspected.

What Are the Treatments?

When a specific cause for 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, drug treatment with antiseizure medications may be recommended.

Medications

Many drugs can eliminate or reduce recurrent seizures. The choice of medication is based on the specific seizure type and pattern. Usually, a single drug is used, but sometimes a combination may be necessary. Common drugs include phenobarbital, Dilantin, Tegretol, Neurontin, Depakote, Lamictal, and Topamax. Many other drugs, for example Gabitril and Keppra, and drug combinations have been developed in the last few years. Many others are in the process of investigation as more is learned about the actual brain mechanisms that cause seizures.

Your doctor may test your blood to make sure you are taking the right amount of medication. Blood tests can also make sure the 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

Surgery may be recommended for the minority of 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, reducing seizure activity in some patients with partial seizures.

In the event of seizures which can't immediately be controlled (status epilepticus), electroconvulsive treatments, (ECT) may be recommended for some patients. This seems to "reset" the electrical activity of the brain, thereby stopping the seizures.

Diet and Lifestyle

Stress may increase seizure activity in certain individuals. Relaxation techniques, biofeedback, and yoga may be helpful when used with medications. A diet known as the ketogenic diet is used under strict supervision in some kids. This diet has helped some children with seizures, but it can be very dangerous.