Connect with others who understand.

Sign up Log in
Resources
About MyEpilepsyTeam
Powered By
See answer
See answer

How Is Epilepsy Diagnosed? Tests and More

Medically reviewed by Chiara Rocchi, M.D.
Updated on April 23, 2025

Key Takeaways

  • Diagnosing epilepsy can be challenging since doctors rarely witness seizures firsthand and symptoms can overlap with other conditions like migraines and sleep disorders.
  • Doctors use multiple tests to diagnose epilepsy, including electroencephalograms (EEGs) to monitor brain activity and various imaging tests like MRI and CT scans to evaluate brain structure, along with taking a thorough medical history and conducting blood tests.
  • Up to 70 percent of people with epilepsy who receive appropriate treatment could become seizure-free within a few years, so it is important to work closely with a healthcare provider to find the right treatment approach.
  • View full summary

Epilepsy can be difficult to diagnose, in part because doctors rarely witness seizures firsthand. The symptoms of epilepsy can also be challenging to distinguish from those of other conditions, including migraine, sleep disorders, heart problems, and more. It’s also possible to have one or more of these conditions in addition to epilepsy, further complicating diagnosis.

It’s important to note that not all seizures are caused by epilepsy. Epilepsy is a neurological disorder that involves recurrent seizures caused by abnormal electrical activity in the brain. Nonepileptic seizures don’t originate from abnormal electrical activity and may require different treatment than epileptic seizures.

Typically, a neurologist (a doctor who specializes in treating the nervous system and brain) diagnoses epilepsy. It may also be diagnosed by a pediatrician, emergency room physician, or general practitioner.

How Do Doctors Test for Epilepsy?

There is no single diagnostic test that can confirm you have epilepsy. Instead, a doctor will consider your medical history and may perform a variety of tests to reach a diagnosis, including electroencephalograms and imaging tests.

Medical History

The doctor will take a thorough history, asking detailed questions about what happens during your seizures, how long they last, and how often they occur. The physician may ask about a history of head injuries, infections, or other neurological symptoms. The doctor will likely ask about your family history of seizures. A clear picture may emerge from the medical history to help the doctor strengthen the suspicion of epilepsy or rule out other conditions.

Electroencephalography

An electroencephalogram (EEG) is used to visualize brainwaves to monitor seizure activity. For an EEG, the technologist administering the test will place electrodes on your scalp. The electrodes pick up the tiny electrical charges resulting from brain activity. Most EEGs record brain activity for 20 to 40 minutes. Receiving an EEG is painless and generally safe.

EEG results are not always clear, as about half of the EEG tests done on people who have seizures look normal. Even if you have frequent seizures, your EEG may be normal if you are not having a seizure during the test. You may be asked to stare at blinking lights or breathe deeply for several minutes to provoke seizure activity.

In addition to a standard EEG, your doctor may suggest an ambulatory or video EEG. Ambulatory EEGs record brainwaves for a longer period of time, usually 24 hours to three days, to increase the chances of recording seizure activity. Electrodes will be placed on your scalp, and you’ll have a small recorder to wear on your waist. Once the electrodes are in place, you can go home and go about your usual routine.

During video EEGs, video and audio of your movement, behavior, and sounds are recorded along with the brainwave patterns recorded in an EEG. Video EEGs allow the neurologist to see what’s happening in your brain during specific seizure behavior. Video EEGs can be done on an inpatient or outpatient basis.

When EEGs do capture seizure activity, they’re very valuable tools. Some brainwave patterns can help doctors know if someone has a certain type of epilepsy, type of seizure, or another brain problem. Sometimes, EEG results can even point to the place in the brain where the seizures start.

If your EEG looks normal, it doesn’t prove whether you have epilepsy or not. More tests will be needed.

Brain Imaging

Imaging tests are performed to evaluate brain function and structure. The most common neuroimaging procedures used to detect brain abnormalities associated with epilepsy are magnetic resonance imaging (MRI), functional MRI (fMRI), and CT scans. Single-photon emission computed tomography (SPECT) brain imaging and positron emission tomography (PET) scans can also be used.

Neuroimaging scans can detect potential causes of seizures, including tumors, scar tissue, abnormal blood vessel formations, or an excess of spinal fluid.

Other Tests

Your doctor may order blood tests to check for other causes of seizures (for example, disorders in your electrolytes or blood sugar) or genetic causes of epilepsy. Blood tests can also screen for infections that may be causing seizures.

The doctor may order a neuropsychiatric test to evaluate cognitive (related to thinking, memory, speech, and reasoning) abilities. A neurological exam may be performed by a doctor, a psychologist, or another specialist.

What Is the Prognosis for Epilepsy?

As many as 70 percent of people diagnosed with epilepsy who receive appropriate treatment could become seizure-free within a few years. Some people will never have another seizure, while others may have sporadic seizures or uncontrolled seizures despite being on anti-seizure medications (ASMs).

What Is Remission From Epilepsy?

The International League Against Epilepsy defines remission from epilepsy as 10 years without having a seizure, with at least five years not taking ASMs. Someone who has gone at least two years without seizures (the last year off ASMs) or five years without seizures (the last two years off ASMs) is considered to be in early remission. The chances for remission are higher for people who take their ASMs consistently, take only one ASM, and start treatment early.

Age at Diagnosis

The age at which a person receives an epilepsy diagnosis varies widely and is often correlated to the cause of epilepsy. Some forms of epilepsy, especially those that are caused by birth trauma or a genetic condition, are diagnosed in infancy or early childhood. Other types of epilepsy don’t develop until adolescence or adulthood.

Talk With Others Who Understand

MyEpilepsyTeam is the social network for people with epilepsy and their loved ones. On MyEpilepsyTeam, more than 124,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

Have you or your child been diagnosed with epilepsy? Which tests helped support your diagnosis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Diagnostic Challenges in Epilepsy: Seizure Under-Reporting and Seizure Detection — The Lancet Neurology
  2. Differential Diagnosis of Seizures — Neurologic Clinics
  3. Association of Epilepsy and Comorbid Conditions — Future Neurology
  4. Non-Epileptic Seizures and Dissociative Seizures — Epilepsy Society
  5. Diagnosis — Epilepsy Foundation
  6. Assembling Your Healthcare Team — Epilepsy Foundation
  7. Evaluation of Medical History — Epilepsy Foundation
  8. EEG in the Diagnosis, Classification, and Management of Patients With Epilepsy — Journal of Neurology, Neurosurgery, and Psychiatry
  9. What If My EEG Was Normal? — Epilepsy Foundation
  10. Ambulatory EEG — Epilepsy Foundation
  11. Video EEG Test — Epilepsy Foundation
  12. Brain Imaging for Epilepsy — Epilepsy Foundation
  13. The Neuronal Sources of EEG: Modeling of Simultaneous Scalp and Intracerebral Recordings in Epilepsy — NeuroImage
  14. The Relative Contributions of MRI, SPECT, and PET Imaging in Epilepsy — Epilepsia
  15. Functional MRI Applications in Clinical Epilepsy — NeuroImage
  16. Computer Tomography — Epilepsy Foundation
  17. SPECT Brain Imaging in Epilepsy: A Meta-Analysis — Database of Abstracts of Reviews of Effects
  18. Epilepsy — Mayo Clinic
  19. Epilepsy — World Health Organization
  20. Anti-Seizure Medication (ASM) — Epilepsy Society
  21. Remission in Epilepsy: How Long Is Enough? — Epilepsia
  22. Seizure Remission and Its Predictors Among Epileptic Patients on Follow-Up at Public Hospitals in Eastern Ethiopia: A Retrospective Cohort Study — International Journal of General Medicine
  23. Seizures and Epilepsy in Children — Johns Hopkins Medicine
  24. Epilepsy for Parents and Caregivers — Epilepsy Foundation
  25. Adult Onset Seizures: Clinical, Etiological, and Radiological Profile — Journal of Family Medicine and Primary Care

A MyEpilepsyTeam Member

People don't understand how tired you get!

All updates must be accompanied by text or a picture.

We'd love to hear from you! Please share your name and email to post and read comments.

You'll also get the latest articles directly to your inbox.

Subscriber Photo Subscriber Photo Subscriber Photo
143,005 members
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service.
Privacy Policy Terms of Use
All updates must be accompanied by text or a picture.

Subscribe now to ask your question, get answers, and stay up to date on the latest articles.

Get updates directly to your inbox.

Subscriber Photo Subscriber Photo Subscriber Photo
143,005 members
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service.
Privacy Policy Terms of Use

How Do You Go About Becoming More Aware (self) To Know When A Seizure Is Near?

By A MyEpilepsyTeam Member 4 answers
View Answers

Thank you for subscribing!

Become a member to get even more