Diagnosing epilepsy

This information is relevant to people who live in the UK.

If you’ve had a seizure, your GP or the hospital where you attended A&E should arrange for you to see an epilepsy specialist. For adults, an epilepsy specialist is usually a neurologist. This means a doctor who’s an expert in conditions that affect the brain and nerves.

How will the specialist decide if I have epilepsy?

There are a number of conditions that can cause symptoms similar to epilepsy, so it can take a while to diagnose. The epilepsy specialist will make a diagnosis mainly based on your symptoms. They may also arrange for you to have some tests.

A description of your symptoms

Your specialist will want to know as much as possible about what happens to you during your seizures. You can help them by:

  • Taking a detailed diary of your seizures to your appointments. This should show the dates, times and a description of what happened, and how you felt before and after
  • Taking someone with you who has seen your seizures. Alternatively, a written description from someone who has seen your seizures would be really helpful
  • Taking some video clips of your seizures to the appointment, if possible

Tests used in the diagnosis of epilepsy

Your specialist may also refer you for some tests to help them make their diagnosis. The most common tests are an EEG test and an MRI scan.

Electroencephalogram (EEG)

The EEG machine records the electrical signals from your brain on a computer. During the EEG test, an EEG specialist places harmless electrodes on your scalp, using a special glue or sticky tape. The electrodes are then connected to the EEG machine, which records the electrical signals onto a computer.  

Magnetic resonance imaging (MRI) brain scan

An MRI scan uses a strong magnetic field to create pictures of tissues, organs and other structures inside the body, on a computer. Some people have epilepsy caused by damage or other problems in their brain, so an MRI scan can check for this.

Other tests

Your specialist might ask you to have some other tests to check your general health and to see if any other conditions may be causing your symptoms. These might include blood tests or a test on your heart called an electrocardiogram (ECG).

What happens if I'm diagnosed with epilepsy?

If the epilepsy specialist diagnoses you with epilepsy, they should tell you what type of epilepsy you have and the name of your seizures. They should also give you information about your treatment options, and about living with epilepsy.


If you would like to know where our information is from, download a copy of this information with references.

Code: 
B004.08

Epilepsy Action would like to thank Dr John Paul Leach, consultant neurologist at the Queen Elizabeth University Hospital, Glasgow, for his contribution to this information.

Dr John Paul Leach has declared no conflict of interest.

This information has been produced under the terms of Epilepsy Action's information quality standards.

  • Updated October 2020
    To be reviewed October 2023

Comments: read the 6 comments or add yours

Comments

Hi my mri showed white matter scars and periventricular signal abnormalities and smaller left hippocampus and slow brain waves on a eeg is this all connected to the seizures that I have ?

Submitted by Rachel walsh

Hi Rachel

I’m sorry but we are unable to answer your question. The results of your MRI and EEG is something your neurologist or family doctor will have to explain to you. After this discussion if you have any further questions, please feel free to contact us again. You can contact us directly, either by email helpline@epilepsy.org.uk  or the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Thursday 8.30am until 8.00pm, Friday 8.30am until 4.30pm and Saturday 10.00am until 4.00pm.

Regards

Diane

Epilepsy Action Helpline Team

Submitted by Diane - Epileps...

hello, as R/N of many years I am looking at on line resources for are staff, hence my undertaking these partly as an update but also to suggest self directed learning for carers, being free can be an added bonus but hence I need to undertake this myself.
Typo on initial page of this section - states ECG performed , you subseequently refer to it as EEG, ECG is not usually part of initial investigations - it is an electrocardiograph, relating to the heart. And could be part of ivestigations but not generally.
Only state this to ensure not confusing readers, the content is very interesting - thankyou

Submitted by Sr. P. Long

Hi

 

Thank you for your feedback. We apologise that we missed it at the time and so there has been a delay in getting back to you.

 

We're pleased you've found our information helpful.

 

Regards

 

Jess

Epilepsy Action Helpline Team

Submitted by Jess - Epilepsy...

I would like to comment for the benefit of visitors to this page that there can be considerable problems experienced in getting a diagnosis in the first place or even getting a pre-existing diagnosis recognised, let alone treated. This is a disappointing reality and your readers need to know they may find themselves up against a fight with medics to get proper tests and care. It is remarkable how many GPs have no real understanding of the condition at all and even Neurologists can see potential sufferers who are not up to speed on the condition and it is important that the consultation with a neurologist is correctly assigned to a suitable consultant with recent up to date training and work with epilepsy treatment.
Your page is helpful but does not explain that video telemetry is the gold standard test for diagnosing epilepsy. This involves 24 hour video recording of a patient in a testing facility with electrodes recording brain activity both awake and while sleeping and eating. This way both visual clues and brain activity can be compared if caught while 'wired up'. Typically recording will take place over 5 days, Monday to Friday. Fortunately the video recording does not follow you into the bathroom or toilet!
This is the best test because it can capture seizures during sleep and also assist patient understanding by being able to compare patient notification of seizures they are aware of with those recorded which they are not aware of. I would have said that I was always aware of my seizures yet my results showed I was unaware of more than half of those caught on video telemetry recordings. It was a surprise but helped me understand my condition better and the confusing and distressing symptoms. It is common for sleep problems and epilepsy to co-exist and I do wish epilepsy sufferers were prescribed sleep more often as it is both free and effective. Seizures in sleep can make you tired in the day and a sense of not being awake fully. This can be baffling when it is not understood or diagnosed and impairs life and functioning. Memory can be impaired with this condition too, again distressing and confusing. Often I just need to sleep to reset my brain and while it is frustrating and inconvenient it is helpful for epilepsy sufferers to realise how much sleep and fatigue are integral to this condition.
Finally this condition can come and go through a lifetime. This can lead to problems as well. So keeping seizure diaries as your article says is so important. If initial tests come back normal this does not mean there is no epilepsy so it is vital any suspected epilepsy sufferer has a door left open to them to be reviewed even if a Neurologist is so bold as to deny any possibility of epilepsy based on a normal MRI and one clear EEG. I know...3 years of fighting to be heard and 3 years left untreated despite an existing diagnosis by a renowned neurologist. So be your own doctor and keep going if getting diagnosed and treated is proving to be a headache. You know yourself and know when something is wrong. Not all seizures are dramatic to an onlooker but they can create profound disturbance within the body.

Submitted by Patient with ep...

Further to the above comment.
There seems to be a ping pong between the GP not wanting to the referral, and another (unrelated) consultant wanting the GP to.
It now makes sense, that it has it is taking so slow to diagnosis when even the professionals won't refer you until a crisis.

Submitted by Tayo David

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