Seizure types 

are organized by whether the source of the seizure is localized (focal seizures) or
distributed (generalized seizures) within the brain.[17] Generalized seizures are divided according
to the effect on the body and include tonic-clonic (grand mal), absence (petit
mal), myoclonic, clonic, tonic, and atonic seizures.[17][50] Some seizures such as epileptic
spasms are of an unknown type.[17]
Focal seizures (previously called partial seizures[13]) are divided into simple partial or complex
partial seizure.[17] Current practice no longer recommends this, and instead prefers to describe
what occurs during a seizure.[17]

Physical examination[edit]

An individual who has bitten the tip of their tongue while having a seizure

Most people are in a postictal state (drowsy or confused) following a seizure. They may show
signs of other injuries. A bite mark on the side of the tongue helps confirm a seizure when
present, but only a third of people who have had a seizure have such a bite. [51] When present in
people thought to have had a seizure, this physical sign tentatively increases the likelihood that a
seizure was the cause.[52]

Tests[edit]

An EEG can aid in locating the focus of the epileptic seizure.

An electroencephalography is only recommended in those who likely had an epileptic seizure

and may help determine the type of seizure or syndrome present. In children it is typically only
needed after a second seizure. It cannot be used to rule out the diagnosis and may be falsely
positive in those without the disease. In certain situations it may be useful to prefer the EEG
while sleeping or sleep deprived.[53]
Diagnostic imaging by CT scan and MRI is recommended after a first non-febrile seizure to
detect structural problems inside the brain.[53] MRI is generally a better imaging test except when
intracranial bleeding is suspected.[6] Imaging may be done at a later point in time in those who
return to their normal selves while in the emergency room. [6] If a person has a previous diagnosis
of epilepsy with previous imaging repeat imaging is not usually needed with subsequent
seizures.[53]
In adults, testing electrolytes, blood glucose and calcium levels is important to rule these out as
causes, as is an electrocardiogram.[53] A lumbar puncture may be useful to diagnose a central
nervous system infection but is not routinely needed.[6] Routine antiseizure medical levels in the
blood are not required in adults or children.[53] In children additional tests may be required.[53]
A high blood prolactin level within the first 20 minutes following a seizure may be useful to
confirm an epileptic seizure as opposed to psychogenic non-epileptic seizure.[54][55] Serum
prolactin level is less useful for detecting partial seizures. [56] If it is normal an epileptic seizure is
still possible[55] and a serum prolactin does not separate epileptic seizures from syncope. [57] It is
not recommended as a routine part of diagnosis epilepsy.[53]

Differential diagnosis[edit]
Differentiating an epileptic seizure from other conditions such as syncope can be difficult.[12] Other
possible conditions that can mimic a seizure include: decerebrate posturing, psychogenic
seizures, tetanus, dystonia, migraine headaches, and strychnine poisoning.[12] In addition, 5% of
people with a positive tilt table test may have seizure-like activity that seems due to cerebral
hypoxia.[58] Convulsions may occur due to psychological reasons and this is known as
a psychogenic non-epileptic seizure. Non-epileptic seizures may also occur due to a number of
other reasons.