Are All Seizures Epileptic?—One of These Other Conditions May Be the Problem

Woman with folded handsBy Cheri Hinshelwood

“Finding a loved one unconsciousness or shaking uncontrollably, or losing track of time yourself can be worrisome,” said Anna-Marieta Moise, MD, an epileptologist and neurologist with Mission Neurology. Because epilepsy is a neurological disorder known for recurring seizures, it is easy to mistakenly conclude all seizures are epilepsy.

“Not all people who appear to have seizures have epilepsy. A few disorders are confused with epilepsy and can be just as serious,” said Dr. Moise. “Because treatment differs from epilepsy, having an accurate diagnosis and getting prompt treatment is really important.”

A Closer Look at Seizures

Seizures are caused by abnormal electrical activity in the brain and result in loss of consciousness, convulsions, unexplained urination or biting of one’s tongue. More subtle signs of epilepsy include odd sensations like tingling on one side of the body, inability to speak, a blank stare for several seconds or difficulty word-finding.

Seizures are diagnosed using an electroencephalogram (EEG), and evidence of seizure “foot prints” can be detected even when a seizure is not happening. “Most patients with epilepsy are treated with anti-seizure medications and lead very productive lives,” said Dr. Moise.

Common Medical Conditions Mistaken for Epilepsy

• Provoked seizure. This is a single seizure caused by low blood sugar, abnormal electrolytes, a high fever or alcohol use. Medically managing these conditions can reduce risk of future seizures.

• Syncope. Also known as fainting, syncope occurs for a variety of reasons. Treating the underlying cause such as low blood pressure or heart disease can reduce future episodes.

• Psychogenic nonepileptic episodes. Trauma or stress can easily be confused with epilepsy. Cognitive behavior therapy with a counselor, psychologist or psychiatrist is an effective treatment option.

“If you’re having a seizure-like episode for the first time, it’s important to call 911,” said Dr. Moise. “Talk with your primary care doctor about a referral to an epilepsy specialist.”

Mission Epilepsy Monitoring Unit

Mission Hospital offers extensive seizure diagnosis capability in its 5-bed inpatient unit. Patients are admitted to a private room in this specialized area of the hospital for one to seven days. Patients are evaluated using an EEG under the care of a certified epileptologist and registered EEG technologists.

While admitted, the team attempts to induce an episode and brain activity is recorded using the EEG. The specialized medical team evaluates results to confirm a diagnosis.

Coming Soon: Tele-EEG Monitoring
Mission Health’s specialized epilepsy team is expanding its expertise to help diagnose and care for more patients with suspected epilepsy outside of the state. Using a remote EEG monitoring system, our team in western North Carolina will be a resource for other HCA Healthcare hospitals in Virginia and Indiana.


Anna-Marieta Moise, MD, is an epileptologist and neurologist with Mission Neurology.

Mission Neurology offers the only trained epileptologists in the region, and our epilepsy center provides patient-centered care for people in western North Carolina with epilepsy and neurological disorders. To learn more, visit missionhealth.org/epilepsy [1].