Diagnosing Epilepsy

The first and most important step in providing a personalized optimal outcome is to reach an accurate diagnosis. While this sounds quite simple, oftentimes it is not. Seizures are a manifestation, a result of an underlying brain disorder, and additional personal information is critical to determining the cause of epileptic seizures. “When did your seizures begin? Do you have a warning before your seizures? What happens to you during your seizures?” Answers to these questions help us better understand the cause of epilepsy in each patient.

Evaluation and Medical History​

When patients are referred to Hoag Epilepsy Program, evaluations begin with a thorough exam and medical history, followed by a complete diagnostic workup. During the exam, patients may be asked the following questions related to their seizures:

Before the Spell:

  • Did you experience lack of sleep or unusual stress?
  • Were you sick recently?
  • Did your eyes, mouth, face, head, arms or legs move abnormally?
  • Were you able to talk and respond appropriately?
  • Did you lose control of your bladder or bowels?
  • Did you bite your tongue or the inside of your cheeks?

After the Spell:

  • Were you confused or tired?
  • Could you speak normally?
  • Did you have a headache?
  • Did your muscles ache?


Specific questions about a patient's medical history may include:

  • Was your birth difficult?
  • Did you have any seizures with high fevers when you were a baby or small child?
  • Did you ever have a head injury? If so, did you lose consciousness after the injury? How long were you unconscious? Were you taken to a hospital?
  • Did you ever have meningitis (an infection of the membranes around the brain and spinal cord) or encephalitis (a serious viral infection of the brain)?
  • Has anyone else in the family had epilepsy, any other neurological disorder, or a disorder associated with loss of consciousness?