HOW WE DIAGNOSE A SEIZURE AND DECIDE WHAT IT WILL MEAN FOR YOUR CHILD: WAS IT A SEIZURE?

After a careful, detailed history, the physician should be able to say one of three things:
1. “That episode was clearly a seizure.”
OR
2. “That was clearly not a seizure. It sounds to me like a fainting spell (breathholding spell, etc).”
OR
3. “I’m not sure what that episode was. I don’t think it was a seizure, but let’s wait and see if it recurs. If it does recur, I want you to observe him carefully and look for …”
Even if a single episode was a seizure, it may not be important for your child’s future since most single seizures do not recur or require treatment. If episodes are recurring, it should not take long for careful observation to determine their true nature. If infrequent and not interfering with the child’s life, they are less important. Rare episodes will either disappear as mysteriously as they appeared, or they will become sufficiently obvious and frequent to allow proper diagnosis.
Many people have been told they have seizures and, subsequently, have been treated with medication because of incorrect interpretation of single events, such as fainting. When in doubt about an event or about the circumstances of it, it is usually better to wait to see if a similar event recurs. It is better to live with uncertainty than to allow yourself or your physician to be too eager to label the event and begin your treatment. If there is doubt about the nature of the event or events, whether or not your child is on medication, you should explore this further with your doctor. Even when your child clearly has had a seizure, different seizures will have different meanings for the child’s future. The meaning may well depend on the context in which the seizure occurred. He may not need extensive evaluation and medication. Decisions about these may depend on the circumstances in which the seizure or seizures occurred.
*18\208\8*

HOW WE DIAGNOSE A SEIZURE AND DECIDE WHAT IT WILL MEAN FOR YOUR CHILD: WAS IT A SEIZURE?After a careful, detailed history, the physician should be able to say one of three things:1. “That episode was clearly a seizure.”OR2. “That was clearly not a seizure. It sounds to me like a fainting spell (breathholding spell, etc).”OR3. “I’m not sure what that episode was. I don’t think it was a seizure, but let’s wait and see if it recurs. If it does recur, I want you to observe him carefully and look for …”Even if a single episode was a seizure, it may not be important for your child’s future since most single seizures do not recur or require treatment. If episodes are recurring, it should not take long for careful observation to determine their true nature. If infrequent and not interfering with the child’s life, they are less important. Rare episodes will either disappear as mysteriously as they appeared, or they will become sufficiently obvious and frequent to allow proper diagnosis.Many people have been told they have seizures and, subsequently, have been treated with medication because of incorrect interpretation of single events, such as fainting. When in doubt about an event or about the circumstances of it, it is usually better to wait to see if a similar event recurs. It is better to live with uncertainty than to allow yourself or your physician to be too eager to label the event and begin your treatment. If there is doubt about the nature of the event or events, whether or not your child is on medication, you should explore this further with your doctor. Even when your child clearly has had a seizure, different seizures will have different meanings for the child’s future. The meaning may well depend on the context in which the seizure occurred. He may not need extensive evaluation and medication. Decisions about these may depend on the circumstances in which the seizure or seizures occurred.*18\208\8*

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