Evaluation

Many people with seizures are first seen in an Emergency room. They are then treated as an outpatient by a neurologist or general medicine physician. Often, the diagnosis can be made by the person’s seizure history. About half of the people who experience a single seizure will never have another seizure, and treatment is not recommended. For those with recurrent seizures, which is epilepsy, anti-epileptic medication is used to control the seizures, and it works in about 70 percent of people.

Some people may require an advanced diagnostic workup for their seizures. This may include people for whom:

• Cause of the seizure is unclear
• Seizures continue to occur despite adequate medication
• Side effects of the medication are intolerable

Outpatient Clinic Visit

At the initial office visit, patients are asked to bring the following information:

• Medical records from outside hospital(s) and doctors
• Standardized seizure questionnaire
• Seizure diary
• Medication log
• Information from someone who has observed the seizure—this person can come to the visit or be available over the phone

At this initial visit, the epilepsy specialty nurse will review the seizure questionnaire, medication log and seizure diary; obtain medical, family and social history; and discuss health concerns. A neurologist who specializes in epilepsy will obtain a detailed seizure history, asking about what the seizures looked like and what happened just before they began. The doctor will also perform a thorough physical examination of the nervous system, checking mental function, such as memory, simple arithmetic, and naming objects, movement, muscle strength, walking, balance and coordination, sensation and reflexes.