Differential Diagnosis for Seizures

Single Most Likely Diagnosis

• Epilepsy: This is the most common cause of recurrent seizures. Epilepsy is a neurological disorder characterized by recurrent, unprovoked seizures. The diagnosis is often made based on the history of seizures, electroencephalogram (EEG) findings, and the exclusion of other causes.

Other Likely Diagnoses

• Head Trauma: Traumatic brain injuries can cause seizures, especially if there is significant damage to the brain tissue. The likelihood of seizures increases with the severity of the trauma.
• Infections (Meningitis, Encephalitis): Central nervous system infections can lead to seizures due to inflammation and irritation of the brain tissue.
• Stroke or Transient Ischemic Attack (TIA): Both ischemic and hemorrhagic strokes can cause seizures, either at the onset or as a later complication.
• Brain Tumors: Tumors, whether primary or metastatic, can irritate the surrounding brain tissue and cause seizures.
• Metabolic Disorders: Conditions like hypoglycemia, hyponatremia, and hypernatremia can lead to seizures due to the imbalance of essential electrolytes and nutrients.

Do Not Miss Diagnoses

• Status Epilepticus: A life-threatening condition where a seizure lasts more than 5 minutes or two or more seizures occur between which the individual does not return to a normal level of consciousness. Prompt recognition and treatment are crucial.
• Subarachnoid Hemorrhage: A type of stroke caused by bleeding into the space surrounding the brain, which can present with a sudden, severe headache and seizures.
• Meningitis: Infections like bacterial meningitis require immediate antibiotic treatment to prevent serious complications, including death.
• Hypoglycemia: Low blood sugar can cause seizures and is easily treatable with glucose administration, making prompt diagnosis critical.

Rare Diagnoses

• Autoimmune Encephalitis: A group of conditions that occur when the body's immune system mistakenly attacks healthy brain cells, leading to inflammation of the brain and potentially causing seizures.
• Mitochondrial Diseases: A group of disorders caused by dysfunctional mitochondria, which can affect various parts of the body, including the brain, and may cause seizures among other symptoms.
• Creutzfeldt-Jakob Disease: A rare, degenerative, fatal brain disorder that can cause seizures, among other neurological symptoms.
• Hashimoto's Encephalopathy: A rare condition associated with Hashimoto's thyroiditis, characterized by seizures, confusion, and altered mental status, which improves with treatment of the underlying thyroid condition.