Assessment and diagnosis of epilepsy

Doctors can find it difficult to diagnose epilepsy as there is not one particular test to use and many other things could be the cause of the symptoms. Also, when someone is not having a seizure his or her brain cells may behave as normal. The person might not be conscious during the seizure so they might not have any memory of it. The diagnosis of epilepsy in people with intellectual disabilities can be especially difficult. The person may be unable to give a clear account of their symptoms because they have no memory of the seizure, or because they find them difficult to explain. In such cases, the doctor may rely on descriptions you give and gather information by getting to know the person, and speaking to other informants/carers.

During the assessment the doctor will ask you and the person you care
for many questions. He or she will need to know how many seizures the
person has had and whether there is any history of epilepsy in the family.
The doctor must be told about any medication the person is taking.
The doctor may ask how the person felt before the seizure, such as
whether they were hungry, thirsty, tired, cold, dizzy or felt sick, or
whether they had unusual chest pains. The doctor will need to know if the
person had drunk any alcoholic drinks before the seizure, and whether
there were any warning signs. The doctor will also ask about how the
person felt after the seizure, andwhether they had hurt themselves at all.
The doctor will ask you questions that the person who had the seizure
might not be able to answer. For example, what the person was doing
before the seizure, and what exactly happened during the seizure. The
doctor will want to know how long the seizure lasted, and whether the
person seemed confused.
Information about the person’s past medical history and behaviour can
help. Aggression, bizarre behaviour, abnormal movements, the side effects
of medication and self-injurious behaviour may all be part of the person’s
everyday behaviour without the presence of epilepsy. However, such
features may also be present in epilepsy.
You and the person you care for might have many questions that you
want the doctor to answer. For example:
‘What sort of epilepsy does the person have?’
‘Why do you think it has developed now?’
‘Will they always have it?’
‘What tests are you recommending and what are you looking
for?’
‘How will you treat the epilepsy?’
‘Is there anything we can do to reduce the side effects of any
treatment?’
‘What will happen if the treatment doesn’t work?’
‘Is there anything that they can’t/shouldn’t do?’