So if someone's coming to the office with seizures, be prepared to have an MRI of the brain, and EEG and a thorough history taken from the physician, or care provider that's treating you. I often talk to my patients about the fact that it's difficult, and I liken the perfect test or I think about the perfect test. And to me the perfect test is a pregnancy test. It's negative or it's positive end of story. You got your answer. In epilepsy and seizures, often that isn't the case. And so we're stuck as physicians trying to make our best diagnosis with the information that's available, recognizing that the information is far from perfect. And so how do I try to make that determination? What do I need to make a diagnosis of epilepsy in a patient? So first and foremost, the history from the patient and it's really, really useful to have the patient, the person coming in and someone else, a friend, family member, preferably who knows them, who can help kind of augment the story. And the idea here is that someone comes, someone's referred to me for a first time seizure, for instance. I want to know, I'm going to be very careful about trying to go back and ask about anything in the past that sounds like a seizure. About 50% of people with a first time seizure who come in for a first time seizure have actually had a seizure in the past. And it's sort of, sometimes because people don't recognize these complex partial seizures, they don't recognize some of the seizures cause they're subtle. They're not obvious. It takes a little bit of fishing this sort of determine that.
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