What is the value of medical history in the diagnosis of epilepsy

  A detailed and accurate history is the basis for a correct diagnosis. It is very useful for both diagnosis and differential diagnosis if the health care provider can witness the seizure, but such opportunities are rare. The main sources of information are the parents, the older child, or other witnesses. Sometimes the seizure is difficult to express verbally, and the person presenting the history can be asked to simulate the performance to help determine the type of seizure.  Current medical history. The following are the main questions: 1. time of onset and age 2. whether there are any aura before the seizure. Not many children with epilepsy have aura, but if they do, it is very important to determine the site of onset of discharge and should be routinely asked about.  3. The starting site of the seizure and symptoms.  4. The evolution and duration of the seizure. Pay attention to how the face looks and what the eyes and mouth show.  5. The presence or absence of consciousness, bowel incontinence and sleep after the seizure.  6. Whether the seizure occurs during the day or at night, and whether there is any relationship with sleep.  7. Whether there is a trigger for the seizure, such as fever, fright, infection, fatigue, strong stimulation, etc.  8. Whether the seizures are frequent and what is the regularity.  9. Treatment history: time of starting medication, type of medication, dose, usage, duration of treatment, effect, adverse reactions, etc.  Personal history 1. Birth history Prenatal: health status of mother during pregnancy, any infection, medication, exposure to radiation, etc., any preterm abortion, intrauterine distress, etc., whether the mother has diabetes, hyperthyroidism and other important diseases. After delivery: whether there was preterm labor, obstructed labor, fetal position, duration of labor, whether there was premature rupture of amniotic fluid, whether sedative drugs and anesthetics were used, etc. Postpartum: whether there is asphyxia, hypoxic-ischemic encephalopathy, intracranial hemorrhage, severe jaundice, whether there are developmental malformations, whether there are convulsions in the neonatal period.  2, feeding history Feeding situation, the presence of rickets, nutritional anemia, malnutrition, etc.  3, growth and development history Focus on neuropsychiatric development, including motor, perception, behavior, language, personality, intelligence, learning and adaptive ability, etc.  Past history Focus on whether the patient has suffered from encephalitis, meningitis, encephalopathy, convulsions, poisoning, head trauma, etc.  Family history Attention should be paid to ask parents, brothers, sisters and other relatives whether they have a history of epilepsy or febrile convulsions, whether they have other neuropsychiatric diseases, whether they have mental retardation, whether parents are consanguineous, parents’ occupation, family economic status, etc.