After you have had a
seizure, it can be difficult to predict whether you
will have more seizures. This makes it hard to decide whether to begin
treatment for epilepsy. The first seizure you report may not actually be the
first seizure you've had. You may have had seizures in the past, such as brief
absence seizures or auras, without knowing they were
electroencephalogram (EEG), especially after sleep deprivation, may reveal abnormalities in the
brain's electrical activity that may help confirm the diagnosis of epilepsy.
MRI scans can be helpful in detecting changes in the
brain that could be related to epilepsy. These tests may be done immediately if the person who has
had the seizure also has a decreased level of consciousness or new motor or
sensory problems that do not improve shortly after the seizure ends. Scans may also be done if the
person has ongoing headache or fever,
AIDS, recent trauma (especially to the head), or a
history of cancer or
anticoagulant therapy. These things increase the
likelihood that the seizure may have been related to a serious problem in the
brain. The nature of the seizure and the person's age can also help determine
whether an imaging test is needed and how soon it is needed.
When deciding to start treatment, you and your doctor can consider how
likely you are to have a second seizure. Risk factors for having a second seizure
Evidence of a structural lesion in the brain as
seen on a CT or MRI scan.
History of an injury to your brain, such as stroke or trauma.
A seizure that occurred at night.
There is some evidence to support the use of antiepileptic medicines
after a first seizure to reduce the risk of more seizures. But medicine
is usually not prescribed if you do not have any of the above risk factors and
are thought to be unlikely to have more seizures. Taking antiepileptic
medicines when you are not at risk for more seizures exposes you to side effects and potential harm from the medicine.
ByHealthwise Staff Primary Medical ReviewerJohn Pope, MD - Pediatrics Brian D. O'Brien, MD - Internal Medicine E. Gregory Thompson, MD - Internal Medicine Adam Husney, MD - Family Medicine Specialist Medical ReviewerSteven C. Schachter, MD - Neurology