Patient: Male, 61 years old, had encephalitis when he was about 20 years old, and had his first grand mal seizure at 38 years old due to excessive grief. 1. Symptoms: sudden loss of consciousness, generalized rigid convulsions, foaming at the mouth, strange screams, and drowsiness after natural cessation. 2. Frequency: In the past, the seizure occurred once every three or four years, but once a year for the past two years. 3. Duration: Each attack lasted less than 5 minutes in the past, but the last two lasted 6 and 10 minutes respectively, and he fell asleep for about 1 hour after stopping. 4. Treatment and diagnosis: EEG had been done when there was no seizure and there was no abnormality; it was not treated because of the long interval between seizures. 5. Trigger analysis: The first time was emotional excitement, then two or three times because of exertion, the last two times really can not find the cause, and the time of occurrence is uncertain, the most recent one was in the early morning sleep, snoring well, and suddenly turned over and had a seizure. I would like to ask: 1. Is it possible to find out the cause and confirm the diagnosis before the attack? What tests are needed? I am 61 years old and getting older, so I am afraid that my body will not be able to cope with it. 3. What are the side effects of medication on the body? Note: The patient is in his hometown, it is not easy to come to the hospital for treatment, and the patient himself is rather reluctant to treat and see the doctor. I hope you can give me help in your busy schedule, thank you very much! The main physician of the Department of Neurology, Shanghai Ruijin Hospital, Liu Xiaoying: In response to your question: 1. The cause of the disease is very much related to your original encephalitis, it is recommended to improve the EEG, 24-hour dynamic EEG if necessary, and MRI (plain scan + hippocampal coronal slice). If the diagnosis is confirmed, epilepsy should be considered based on the medical history you provided. 2. You need to start medication, otherwise the seizures will become more frequent. If you do not want to take medication, you can wait until you have 2-3 seizures per year and then start taking medication. 3. Different antiepileptic drugs have different side effects. It is recommended to provide other detailed medical history, which will help the doctor to consider them comprehensively when prescribing.