Seizures

After a seizure, your healthcare professional reviews your symptoms and medical history and does a physical exam. You may have tests to find the cause of your seizure. Tests also may show how likely it is that you’ll have another seizure.

Tests may include:

• A neurological exam. This is to look at your behavior, motor abilities and how your brain works.
• Blood tests. A blood sample can show blood sugar levels and look for signs of infections or gene conditions. A health professional also may check the levels of salts in the body that manage the balance of fluids. These salts are called electrolytes.
• A spinal tap. This procedure collects a sample of fluid from the spine for testing. Also called a lumbar puncture, a spinal tap may show whether an infection caused a seizure.
• An electroencephalogram (EEG). In this test, electrodes are put on the scalp to record the electrical activity of the brain. The electrical activity shows up as wavy lines on an EEG recording. The EEG may show a pattern that tells whether a seizure is likely to happen again.

  EEG testing also may help rule out other conditions that have symptoms like those of epilepsy. This test may be done at a clinic, overnight at home or over a few nights in the hospital.

Imaging tests may include:

• MRI. An MRI scan uses powerful magnets and radio waves to create a detailed view of the brain. An MRI may show changes in the brain that could lead to seizures.
• CT scan. A CT scan uses X-rays to get cross-sectional images of the brain. CT scans can show changes in the brain that might cause a seizure. Those changes may include tumors, bleeding and cysts.
• Positron emission tomography (PET). A PET scan uses a small amount of low-dose radioactive material that’s put into a vein. The material helps show active areas of the brain and brain changes.
• Single-photon emission computerized tomography (SPECT). A SPECT test uses a small amount of low-dose radioactive material that’s put into a vein. The test creates a detailed 3D map of the blood flow in the brain that happens during a seizure.

  A healthcare professional also may do a type of SPECT test called subtraction ictal SPECT coregistered with MRI (SISCOM). The test may give results with even more detail. This test is usually done in a hospital with overnight EEG recording.