DIAGNOSIS CHECKLIST
for Seizures

Why: e.g. loss of consciousness, various movements, incontinent of urine or feces, bite tongue, drowsy after the attack, residual weakness of the limbs after he attack- The diagnosis of epilepsy is made on the history rather than the EEG so very detailed description of the events from eye witnesses is important.

Why: This helps determine the type of seizure. Loss of consciousness is a feature of generalized seizures. In complex partial seizures, consciousness is clouded so that the person does not recall the complete seizure.

Why: This helps determine the type of seizure e.g. muscle jerking is involved in tonic clonic seizures, clonic seizures, absence seizures (muscle jerking is minor, and mainly of the face) and myoclonic seizures.

Why: This helps determine the type of seizure e.g. If a seizure begins with focal muscle jerking, it is a partial seizure.

Why: e.g. at night, in bed, after exposure to computer and video games.

Why: e.g. fatigue, lack of sleep, stress, physical exhaustion, excess alcohol, prolonged flashing lights.

Why: e.g. change in mood or behavior - The presence of a prodromal period adds weight to the diagnosis of epilepsy, but does not help distinguish the type.

Why: The presence of an aura may help distinguish the type of epilepsy. An aura may be a strange feeling in the gut, or a sensation, or an experience such as déjà vu (a disturbing sense of familiarity). An aura implies a partial seizure, often, but not necessarily, temporal lobe epilepsy.

Why: may suggest a Jacksonian convulsion which is when a seizure involves the part of the brain responsible for movement.

Why: e.g. lack of oxygen during childbirth may cause medial temporal sclerosis which is a cause of seizures.

Why: Head injury is sometimes followed by epilepsy within the first week or many months or years after.

Why: e.g. brain metastases may cause seizures. The most common sites of origin are lung cancer, breast cancer, melanoma, kidney and bowel; medical conditions that may cause seizures include stroke, high blood pressure, systemic lupus erythematosus, multiple sclerosis, polyarteritis nodosa, sarcoid, low blood sugar, chronic renal failure, porphyria, low blood sodium, high blood sodium, low blood calcium, liver disease, encephalitis, syphilis and HIV.

Why: e.g. some medications may lower the seizure threshold or cause seizures in overdose including phenothiazines, tricyclic antidepressants, monoamine oxidase inhibitors and lignocaine; withdrawal of benzodiazepines such as valium may cause seizures.

Why: e.g. alcohol withdrawal may cause seizures; excess alcohol may trigger seizures in an epileptic person.

Why: e.g. cocaine may cause seizures; marijuana use can trigger seizures in epileptic people.

Why: About 30% of people with epilepsy have a history of seizures in first degree relatives.

Why: e.g. people with epilepsy can hold down most jobs, but if they are liable to seizures they should not work close to heavy machinery, in dangerous surroundings, at heights (e.g. on ladders) or near deep water. Careers are not available in some services, such as police, military, aviation or public transport.

Why: Most activities are fine, but epileptics should avoid dangerous sports such as scuba diving, hang gliding, parachuting, rock climbing, car racing and swimming in the surf alone.

Why: may suggest meningitis, encephalitis or brain abscess. High fevers in children under the age of 5 years are sometimes associated with generalized seizures (febrile convulsions).

Why: may suggest brain tumor, brain abscess, brain hemorrhage or hydrocephalus.

Why: e.g. brief (10 second) pauses such as stopping talking mid sentence and then carrying on when left off; sudden onset and termination.

Why: e.g. sudden onset, loss of consciousness, limbs stiffen (tonic) then limbs jerk (clonic), drowsy afterwards.