Diagnostic Procedures

Doctor examines boy
Diagnosis is an important stage in understanding the cause of your child’s seizures. It will involve a detailed patient history and may involve several tests. Note that in some cases, test results in a child with epilepsy can be completely normal. There is no one test that can always identify epilepsy. This is why a patient history and your observations of your child’s seizures are an essential part of diagnosis: you are the person who knows what is and is not normal for your child. The child’s own description of her seizures is also important and can provide a lot of information for her doctor.

Because it can be difficult to remember everything important when you are in the doctor’s office, it will help to write down your observations and bring them with you. If you have video equipment, you may wish to record your child’s seizures for the neurologist to see. This information can help identify the type of epilepsy your child has and can also help the team choose the most appropriate treatment for your child.

Each meeting with your child’s doctors and other medical professionals during diagnosis is important, and can be difficult emotionally. For these reasons, bring paper and a pen and take notes to help you remember the new information you may be learning and to write down questions as you think of them. You may also bring a relative or friend to take notes for you.

What will happen during diagnosis

History

The history includes your and your child’s description of her seizures -- what she felt and what you observed before, during, and after the seizures. The doctor will also ask questions about the child’s health and her development up to now, how she is doing in school, and whether any family members had seizures.

Physical examination

A physical examination may be carried out by a physician, nurse practitioner, or medical resident. It’s a way of checking for any problems with the body. The physical examination will include a neurological examination, which looks for problems with the brain or nerves.

Diagnostic tests

Diagnostic tests are tests ordered by a doctor to help figure out the cause and type of any problem. For some of these tests, your child will need to be sedated or anaesthetized. You will be told about the test before your child has it, along with certain things you will need to help prepare your child for the test.

The history, physical examination, and the most important diagnostic tests are described in detail in this section. Click the links on the left to learn more.

Will your child need to have a lot of tests?

Your child may need to have several tests if the source of the condition is not immediately obvious. Sometimes results from one test may be inconclusive and the doctor needs to try some others to either rule out or confirm a diagnosis.

How can you help your child get through tests?

The health professionals who will be giving your child tests are very skilled at what they do, and skilled at working with children. They will be as gentle and efficient as possible. They will take into consideration your child's age and experiences and adjust their approach accordingly. If a procedure is expected to cause significant pain, sedation or anaesthetic will be used.

As a parent, when pain or discomfort is expected with tests or treatments, encourage your child to breathe (some children tend to hold their breath in response to pain), stay calm yourself and don't fuss, help your child think of other happier thoughts (sometimes distracting them works), and hold them or stroke them as appropriate, depending on their age.

Elizabeth J. Donner, MD, FRCPC

2/4/2010


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