The Initial Diagnosis

A person who has a first seizure in their adult years needs a thorough work-up, just like anyone else. Yet, some things are especially important to consider:

  • Focal seizures, also known as simple partial seizures or complex partial seizures, are more common in adults than generalized seizures. Since these seizures are often overlooked or mistaken for other problems, it’s important to write down what is seen.
    • If possible, videotape an event with a camera or smartphone and take it to your first appointment with a neurologist.
    • If you are a health care provider seeing someone for a first seizure, the history from the individual and an observer will be very critical.
  • Sorting out what may cause seizures to begin in adults is the first step. This may be done in an emergency room if a person is taken to a hospital with the first seizure. Other times, this will start in an office visit. A primary care provider may start by looking at treatable causes and other health conditions. A referral to a neurologist is recommended.
    • The most common causes of new onset seizures in adults are structural changes in the brain (for example, stroke, tumor, or brain injury) and infection of the brain.
    • In about 60% of people we don’t know the exact cause of epilepsy.
    • An MRI scan (magnetic resonance imaging) should be done in any person who starts having seizures as an adult. This test will look for treatable causes, such as a tumor or infection. It can also help localize areas where seizures may begin or give information about other neurological problems.
    • If seizures are difficult to diagnose, an epilepsy specialist at a comprehensive epilepsy center can offer more advanced diagnostic testing and treatment.

The Initial Diagnosis — John Hixson, MD

Authored By: 
Patty Obsorne Shafer RN, MN
Authored Date: 
Reviewed By: 
Joseph I. Sirven MD
Monday, November 28, 2016