Symptoms & diagnosis of Epilepsy – Epilepsy Learner Video 2

This article is based on a video from Nayi Disha’s “Parent education series” on Epilepsy and seizure management. In this video Dr. Nikit Milind Shah talks about the symptoms and diagnosis of epilepsy.

Do you have a child who is experiencing seizures, or do you know of one who is? When seizures occur repeatedly, this condition is termed Epilepsy – a common neurological condition. The more we learn about it, the better we can fight it together. Our goal is to empower concerned parents with the knowledge and confidence needed to help their child grow into a self-assured, resilient young adult.

In order to provide appropriate care and support, the first step is to identify and recognise a seizure episode.

Some common symptoms of a typical seizure

1. Tightening of the body
2. Jerking of the limbs

These signs are usually clear and rarely missed by caregivers. However, there are other symptoms that are not very common and can be missed by most people, unless preemptively asked by the doctor. 

Less common symptoms of seizures:

1. Myoclonic jerks – sudden, brief, light jerks of the body. 
2. Infantile spasms – sudden jerks of the whole body, often seen in babies during twilight phases (just before sleep or right after waking).
3. Absence seizures – staring spells lasting 15–20 seconds, without loss of posture. These can occur multiple times a day.

Why is identifying subtle seizures important?

• These less obvious symptoms are often missed unless specifically asked about by a doctor.
• Delays in recognizing them can mean families approach a neurologist only after the condition has worsened.
• Early identification ensures timely treatment, reducing risks and improving the child’s daily functioning.

Why is early diagnosis of Epilepsy important?

• Repeated and uncontrolled seizures can harm the developing brain. Timely diagnosis allows doctors to intervene early, reducing the risk of long-term damage.
• Effective treatment helps children feel more comfortable, reducing pain, fatigue, and frustration that often accompany seizures. 
• Seizures can cause anxiety, irritability, or behavioral concerns. With proper management, children experience fewer disruptions, leading to greater confidence and stability in daily routines.

Diagnosis and assessment

• Unlike some conditions, there isn’t a simple test that can confirm seizures. Diagnosis relies on careful observation and information gathering.
• The history provided by an adult who has seen the seizure is crucial. Details such as what the child was doing before the event, whether they had eaten, how much sleep they had, or if they had a fever help doctors understand possible triggers.
• The doctor combines witness accounts with the child’s medical history, current concerns, and any additional evaluations to arrive at the most accurate diagnosis

Diagnostic tools

Electroencephalogram (EEG)

EEG records brain waves during seizures and is used for evaluation in children presenting seizures, though not all conditions warrant an EEG.

When is an EEG performed?

1. To check brain activity in a non convulsive state and determine whether they have any internal seizures
2. To observe changes in the brain between seizures also referred to as the interictal period. 
3. To locate the focus of the seizures in focal epilepsy
4. To classify electrical syndromes

However, it is difficult to capture an EEG during seizures, especially if the seizures are less frequent. Most often, an EEG is ordered to be performed in between seizures, where subtle changes can still be detected.

Magnetic Resonance Imaging (MRI)

Produces detailed images of the brain to identify structural or functional changes in the brain that may have caused the symptoms of epilepsy. 

When is an MRI performed?

1. Detects structural abnormality
2. Helps investigate unusual electrical activity seen on EEG
3. Provides higher-resolution images when needed

An MRI and EEG are usually sufficient for diagnosing epilepsy. However, in some cases, epilepsy is part of a broader condition. Additional tests help doctors uncover underlying causes, ensuring the child receives the most effective treatment and support

• Lumbar puncture
• Cerebro Spinal Fluid (CSF) analysis 
• Single-Photon Emission Computed Tomography (SPECT) scan
• Metabolic screening
• Genetic testing

Parents and caregivers are the first line of support. By observing, recording, and sharing details of seizure episodes, you give doctors the essential tools they need to make the right diagnosis and guide treatment.

Watch this video to understand

– Ways to understand and interpret seizure signs and symptoms
– Tools used to confirm diagnosis

DISCLAIMER: Please note that this guide is for information purposes only. Please consult a qualified health practitioner for safe management.

Additionally, also watch this video about treatment and management of Epilepsy.

If you have questions about Autism, Down Syndrome, ADHD, or other intellectual disabilities, or have concerns about developmental delays in a child, the Nayi Disha team is here to help. For any questions or queries, please contact our FREE Helpline at 844-844-8996. You can call or what’s app us. Our counselors speak different languages including English, Hindi, Malayalam, Gujarati, Marathi, Telugu, and Bengali.