The doctor will need to perform a number of tests to determine the diagnosis of epilepsy, from a basic neurological physical examination to imaging tests such as an MRI. Neurological examinations The doctor may check the child’s motor skills, behavior, and intelligence to understand how the convulsions are affecting the child. Blood tests The doctor may check for items related to convulsions, such as infection, electrolyte imbalance, anemia or diabetes. Your doctor may recommend special tests to see if there are any abnormalities in the brain, including: Electroencephalogram (EEG) This is the most basic test to diagnose epilepsy. Electrodes are placed in the head to record the electrical activity in the brain. If a child has epilepsy, the EEG will usually have some abnormal changes, even if there are no convulsive seizures at the time. The doctor may want to do a video screen EEG to look at the child’s seizures both awake and during sleep and to clarify the type of epilepsy. Sometimes something needs to be done to induce a convulsive seizure, such as sleeping less the night before the EEG is done. CT Most places have CT exams. A CT exam may be done when your child has a first convulsive seizure emergency. CT exams will have X-rays that examine a cross section of the skull and can show some of the lesions that cause convulsions such as: tumors, bleeding, cysts, etc. Nuclear magnetic imaging (MRI) uses a magnetic field and provides similar information to CT, but with more detailed images of brain tissue and may show the brain lesions that cause convulsions. Functional MRI (fMRI) shows changes in blood flow in specific parts of the brain and is usually done before surgery to determine the exact location of certain important functions such as speech and to avoid accidental injury during surgery. PET Intravenous injection of a small amount of radioactive material to show areas of abnormal brain activity and determine the site of the lesion SPECT This test may need to be done during a convulsive seizure when the EEG and MRI cannot identify the lesion, and requires an intravenous injection of a small amount of radioactive material Neuropsychological tests including IQ, memory, and language to help the surgeon determine the exact onset of the convulsion, usually before epilepsy surgery