Health News and Information

The first time you or anyone in your family has a fit, you should consult a doctor. Often there may have been some obvious reason for the fit (if it followed alcohol withdrawal after a period of heavy drinking, for example, or if it occurred in a child during a high fever), and in this case your doctor may not suggest any further investigations or recommend any anticonvulsant medication. However, if there was no obvious reason for the fit, or if the doctor feels it is necessary, he or she will almost certainly suggest that you undergo a thorough investigation to discover whether your fits are likely to recur and whether there is any underlying cause for them that can be treated.
MAKING THE DIAGNOSIS
The diagnosis of epilepsy is made by looking at what happens during the seizures. There are plenty of other reasons besides epilepsy for sudden attacks of unconsciousness or odd behaviour, and all of these will have to be ruled out before a final diagnosis of epilepsy can be made. Fainting, breath-holding attacks, night terrors, migraine, episodes of day-dreaming or inattentiveness in schoolchildren, aggressive outbursts in disturbed adolescents – all of these can be, and quite often are, mistaken for epilepsy.
So before making the diagnosis your doctor will want to have as much information as possible about you. You’ll be asked whether anyone else in your family has ever suffered from epilepsy. You will be given a full physical examination, and your doctor will want to know your medical history and exactly what happened when you had your attack. Your own recollection of events and eyewitness accounts of anyone who was with you at the time will all help the doctor decide whether what you experienced was, in fact, an epileptic attack, and if so, what kind. These are some of the questions you will probably be asked:
What was happening at the time of the seizure?
Were you particularly tired, for example? Had you been drinking or had you missed a meal and were very hungry? Were you watching television, or were you at a disco? Was it very hot? Did it happen after you had just stood up and were feeling faint?
Have you recently had a blow on the head?
Or have you at any time in the past suffered a head injury severe enough to render you unconscious or keep you in hospital for observation? Any significant head injury may increase the chances of you developing epilepsy in the future.
Does any member of your family suffer from epilepsy?
Do you suffer from any chronic illness?
Have you recently had an infectious illness?
Have you been under particular pressure lately, or been very worried about anything?
What did you or those around you notice about the seizure itself?
What was the very first thing you noticed when the seizure started? Was it an odd smell or taste, for example, some weird sensation or thought or an involuntary movement like the twitching of a hand or arm? If there was any jerking or twitching, how did it spread? What part of the body was affected before you lost consciousness? Did it affect one side or both sides of your body and how long did it last? Be as specific as you can. It is these observations which will help your doctor decide which part of your brain gave rise to the seizure.
Did you fall to the ground during the seizure?
Did you lose consciousness during the seizure?
What happened immediately after the seizure?
If anyone was with you, did they notice whether you changed colour? Did you seem confused after the seizure and if so, for how long? As you were coming round, did they notice any difficulties in your speech? Was it slurred, for example, or did you have difficulty finding the right words?
How did you feel after the attack?
Did you notice any weakness in your limbs after the attack? Did you have a headache or feel depressed? Did you fall asleep after the attack? Or did you feel much better afterwards?
How much memory do you have of the event?
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The pathways of chemical metabolism in the newborn are very unstable and vast changes in the serum concentrations of various substances can occur. A blood glucose concentration sufficiently low (hypoglycaemia) to cause seizures, for example, cannot be induced in older children or adults by starvation, or indeed by any means other than the injection of insulin. However, severe hypoglycaemia resulting in seizures may be seen in the newborn, particularly in premature infants, or in babies born to diabetic mothers.

Seizures due to a low serum calcium are also fairly frequent in the newborn period. One cause is early feeding with cow’s milk, which is very rich in phosphates, and which results in increased renal excretion of calcium and subsequent low levels of calcium in the blood.

In later stages of life, other acquired metabolic disorders may cause seizures. Chronic renal failure used to be one of the more common causes, but dialysis and successful transplantation of kidneys has reduced the frequency of seizures due to this cause.

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