A person's journey with epilepsy often starts with a specific event or when the person, family, or friends see unusual sensations, behaviors, or movements. What happens next is often determined by whether it’s an emergency situation.  

 

Moderator: Patty Osborne Shafer RN, MN, is an epilepsy clinical nurse specialist at the Comprehensive Epilepsy Center, Beth Israel Deaconess Medical Center in Boston, and the associate editor and community manager of epilepsy.com.

Speakers:

  • Nathan Fountain MD is a professor of neurology and director of the Comprehensive Epilepsy Program at the University of Virginia and chair of the Epilepsy Foundation’s  Professional Advisory Board
  • Sandra Dewar RN, MS, is a clinical nurse specialist at the Seizure Disorders Center at University of California in Los Angeles. 

Non-urgent Situations

Typically, when unusual sensations, behaviors, or movements are noticed, the first step is to visit the primary care provider. This kicks off the process of trying to figure out what’s happening. There are lots of things that can mimic or look like seizures and these need to be checked out first.

Based on what your primary care provider finds in a physical exam, other steps may include:

  1. Get more information. Write down what happens, how often, how long they last, and how you feel. Use a watch to time the events.
  2. If more events occur or concerns are found on a general exam or in blood tests, an EEG and imaging tests (such as a CT scan or MRI) are recommended.
  3. If symptoms continue and concerns arise from the EEG and imaging study, or there is a family history of epilepsy or other neurological problems, a referral to a neurologist would be the next step.
  4. If a child presents with suspected seizures, it’s important to see a child neurologist to look at all possible causes. 
  5. If an older adult presents with seizures, they should see a neurologist and ideally a specialist in epilepsy as soon as possible. Seizures can be related to or confused with other medical problems. It’s important to sort this out quickly so proper treatment can be given.

Urgent Situations

When a first seizure occurs in public with loss of consciousness or injury and you are taken by ambulance to an emergency room, the medical team there will likely take these steps.

  1. The emergency department will examine you and order blood tests. They may also bring in a consulting neurologist.
  2. Imaging, such as a CT or MRI, may be ordered if any of the initial results are abnormal, they suspect continued seizures, or you have a history that indicates you had other seizures.
  3. Outpatient imaging may be ordered if your examination and blood work show no abnormalities or if the emergency department does not have access to this type of equipment.
  4. Additional tests may be ordered for initial diagnosis pending symptoms and findings.

 

Authored By: 
Patty Obsorne Shafer RN, MN
Authored Date: 
11/2015
Reviewed By: 
Joseph I. Sirven MD