Doctors use several approaches to determine if a person has a seizure disorder, the type, and its extent.

Gathering information

An important tool for the doctor is gathering as much information as possible about what the seizures looked like and what happened just before they started. Sometimes other people—family, friends, or coworkers—can better describe what happened after the seizure started, since the person who had the episode often cannot. Download a seizure diary which is useful for keeping track of this information.

Testing

EEG—A doctor also diagnoses epilepsy using an electroencephalogram (EEG), a painless test that measures electrical activity in the brain. Electrical signals from brain cells are picked up by small wires placed on the head and recorded as wavy lines by a special machine. The brain waves may show patterns that are typical of certain seizure types.

CT/MRI—Once epilepsy is suspected, computed tomography (CT) or magnetic resonance imaging (MRI) scans of the brain may help pinpoint a cause. These record pictures of the brain to see if there are any growths, scars, damage from injury or stroke, or other physical conditions that might be producing seizure activity.

Other tests—The doctor may order blood tests, liver and kidney function studies, an electrocardiogram (ECG) measuring heart function, and other tests to find other possibly treatable causes of seizures.

Treating epilepsy

Epilepsy is typically treated with medicines, a special diet, lifestyle changes, or in some severe cases, surgery. If you experience seizures, your doctor can help determine which treatment is right for you.

Drug therapy—Treatment with medicines is most common and is usually tried first. There are different drugs that can be used, depending on the type of seizures, and doctors often attempt to use one drug at a time if possible. No single drug can manage all types of seizures. Some people have their seizures managed with a single drug; others must take several.

Medications that are prescribed for seizures should be taken regularly as prescribed.

Diet—A special diet very high in fats—called a ketogenic diet—sometimes helps prevent seizures, especially in children. It must be prescribed and monitored by a doctor, and is usually tried only if medications and other treatments do not work effectively.

Surgery—If medication fails to control the seizures, or if epilepsy is caused by a brain tumor, surgery might be recommended. It is usually tried only if seizures begin in a small area of the brain. Treating that small portion may stop the seizures or greatly reduce them, without damaging the patient's ability to function in other ways. Surgeons will operate only when the possible benefits outweigh the risks.