Diagnostics

The diagnosis of an epileptic seizure always includes an initial consultation in which the doctor will ask certain questions: Since many other clinical pictures could be possible, a detailed physical examination must be carried out. Circulatory and metabolic disorders, as well as depression, anxiety or migraines, can be similar to an epileptic seizure. In addition to a purely physical examination, an imaging diagnosis must also be carried out.

Here, the EEG (electroencephalogram) plays a decisive role. The EEG can often filter out important causes for the development of cramping disorders. However, it should not be forgotten that in many cases the EEG during a seizure can be completely normal.

Another important examination is the ECG, since a cardiac arrhythmia should be excluded as the cause of a circulatory collapse. In addition, a blood test should be performed. Here, the liver and kidney values, the blood electrolytes and the blood sugar are checked.After a seizure, the enzyme creatine kinase is often elevated, which is why this value is often also examined.

A lumbar puncture is also occasionally used as a diagnostic tool, since encephalitis can also cause epileptic seizures. Further imaging of the brain by means of MRI serves to rule out or secure an epileptic seizure. Especially if certain risk factors such as circulatory disorders or other injuries in the brain become apparent, which make epileptic seizures more likely.

When was the time of occurrence?
Where was the seizure?
Was there a recognizable trigger?
What signs could be observed during the attack by outsiders?
Did you have aura-typical symptoms (taste, smell, tingling, etc. )?

First aid in epileptic seizures

If you now see someone who has just had an epileptic seizure, you must first remain calm, as the seizure usually ends after two to three minutes. The space around the person having the seizure should be cleared as far as possible (e.g. clearing away chairs) so that the person having the seizure does not injure himself. Afterwards, the rescue service should be called immediately (112).

Under no circumstances should the head be supported or the cramping person held in place, as this increases the probability of injury to both the cramping person and the helpers. Most people are unconscious after the seizure. They should be checked to see if they are breathing and then they should be brought into a stable lateral position.

It should also be checked regularly that the person is still breathing while waiting for the rescue service. If breathing stops, cardiopulmonary resuscitation should be initiated. If possible, it is also important to keep a good eye on the clock when the seizure begins in order to make a good estimate of the duration of the seizure.

Without a watch, even experienced persons will often significantly overestimate the duration of a seizure. There are also emergency medications, but these are only used if the seizure lasts longer than five minutes. These may be benzodiazepines administered rectally (through the anus) or through the nose or mouth.