Diagnosing epilepsy

A GP will usually refer anyone who has had a first suspected seizure to a first seizure clinic or epilepsy specialist at the hospital.

A diagnosis of epilepsy should always be made by an epilepsy specialist, which is usually a neurologist at your hospital. 

The specialist will do a basic clinical examination and take a detailed medical history. They will also want to speak to anyone who has witnessed the suspected seizure. If you have video footage of the suspected seizure(s), take this with you to the appointment.

A diagnosis is usually made by ruling out any other medical conditions that can cause a seizure.  There is no single test to diagnose epilepsy. There are, however, some tests that can confirm the diagnosis of epilepsy and can help identify the cause and/or type of epilepsy.

Some of the possible tests are: 

• An ECG (electrocardiogram) which can rule out an irregular heartbeat or other heart condition as the possible cause of a suspected seizure. 

• A blood test which can rule out diabetes, or any other medical condition which could cause seizures. 

• An EEG (electroencephalogram) which records the brain’s electrical activity. During a seizure, this electrical activity is disrupted, and will show up on the recording if the person has a seizure during the test.  It can also sometimes show an abnormal pattern in between seizures.

• Brain scans look for anything which may be causing the seizures, such as scarring on the brain or a tumour.  The scan is usually an MRI (Magnetic Resonance Imaging) scan.  Sometimes, you may get a CT (Computerised Tomography) scan if the hospital has no MRI scanner.

A clear EEG and brain scan does not rule out epilepsy, in fact many people will be diagnosed with epilepsy even though all their tests have come back clear. All this means is that there is no obvious cause for epilepsy.

For more detailed information about what to expect when being diagnosed with epilepsy, read our Diagnosing epilepsy publication.