Diagnosis
Only about 25 percent of people who have a seizure or develop status epilepticus have epilepsy. It is important to distinguish primary epileptic seizures from secondary causes. Blood tests, lumbar puncture or toxicology screening can be helpful in specific circumstances suggestive of an underlying cause like alcohol or benzodiazepine withdrawal, meningitis or drug overdose, but there is insufficient evidence to support their routine use in the work-up of an adult with an apparently unprovoked first seizure. A 2007 review recommends an electroencephalogram and brain imaging with CT scan or MRI scan in the work-up. MRI is more sensitive in a first apparently unprovoked seizure.
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