Your primary doctor may be the first provider to check you for epilepsy. They may then refer you to a specialist. This may be a doctor who treats the brain (neurologist). Or it may be a neurologist who focuses on seizure disorders. They will take a health history and do physical and nervous system exams. They will also have you take some tests. A diagnosis is typically made if you have more than one seizure for no clear reversible reason. (This is called an unprovoked seizure.)

This is the key part of your exam. The doctor will ask you to describe your seizures. This will include information on how long they last, how often they occur, if you sense them starting (an aura). You'll also be asked what they look like and what happens when they are done (your postictal state). The doctor will also ask if anything unusual triggers your seizures, such as repeated sounds, flashing lights, video games, or touching certain parts of your body.

Your sleep history will also be looked at since sleep deprivation can increase your risk for a seizure. Because some people can't remember their seizures, witnesses may be needed. So your doctors may want to talk with family or friends who have seen your seizures. And they will ask about your risk factors. These are things that make you more likely to have epilepsy, such as:

• Being born before your due date (premature birth).
• Oxygen deprivation during birth.
• A family history of epilepsy or other brain system problems.
• Past nervous system infection, such as meningitis or encephalitis.
• A past head or brain injury or surgery.
• Past stroke or brain tumor.
• A history of childhood seizures caused by high fever (febrile seizures).
• Use of illegal drugs or alcohol.
• Some genetic disorders.
• Alcohol or drug abuse or withdrawal.
• Alzheimer disease.
• Gluten intolerance or celiac disease.
• Abnormal fluid buildup around the brain (hydrocephalus).
• Withdrawal of antiepileptic medicines, even when they are used for other conditions (such as gabapentin for pain).

The physical exam checks your overall health. Your pulse, blood pressure, and temperature are taken. The neurologic exam checks certain functions of your brain. These include reflexes, balance, muscle strength, and coordination. Mental skills, such as language and memory, and nerve function of the body are also checked.

After the exams are done, you may need some tests. Electroencephalogram (EEG) and MRI are the most common tests used to check for epilepsy. Sometimes a lumbar puncture is needed. This is often done if the doctor thinks there may be infection or inflammatory problem of the brain.

An EEG is a painless test that records electrical activity in the brain. It can show abnormal signals that may mean seizure activity. In some cases, it can point to the part of the brain where seizures might start and help find out if antiseizure drugs can help. Sometimes video monitoring is also used along with the EEG to help rule out other disorders that may look like epilepsy.

These may be used to create detailed pictures of the brain. These tests include MRI and CT scans.

You may have a blood sample taken and tested. Other tests may also be done. These tests can help rule out other health problems or provide more information.