Seizure disorders may be caused by any pathological processes within the central nervous system (CNS) (McCance & Huether, 2014). The onset of a seizure may be an indication of an ongoing major neurological ailment. Various factors may cause these manifestations and are classified into etiologic factors and metabolic defects. Etiological factors include cerebral trauma, epilepsy, cerebral lesions, and biochemical disorders. The following case study reveals more about the physical examination and laboratory tests that must be conducted for a patient who had seizure. Here you may buy essays on similar or any other topic you may need.

The Questions to Be Asked

The first question the physician would ask the patient is to describe the seizures. A doctor can diagnose a seizure based on patient’s description or the symptoms observed before the occurrence of its episode (Nowacki & Jirsh, 2017). Depending on the description, medical history, and symptoms, a doctor may gain the basis to order several tests, including spinal tap, blood tests, and brain imaging scans to determine the cause of the seizure. The other questions that could be asked should address the history of neurological disorders or seizures in the family, any drug use, especially the recreational ones, including alcohol, as well as prior trauma of the head or a CNS infection (Sun et al, 2017). Finally, the physician should inquire about any rare triggers, for example, flashing lights, touching certain body parts, repetitive sounds, or sleep deprivation.

Physical Exam

A physical exam is necessary to differentiate between pseudoseizures and true seizures. The physician would first ensure that the patient has normal vital signs, no further seizure activity, and adequate oxygenation. The next step would be examining his physical body to determine, whether the patient did lose consciousness, bit the tongue, or had a prolonged confusion after regaining consciousness, which are the indicators of true seizures. To distinguish between pseudoseizures and true seizures, several characteristics should be addressed and taken into account (McCance & Huether, 2014). For example, the duration of pseudoseizures is often longer, and they are not followed by postictal confusion. Vital signs, such as temperature and blood pressure, usually remain normal, but the patient often persists passive eye opening in case of pseudoseizures. Another important part of physical exam is checking for bruises to understand, if there has been any trauma, and for asymmetries in the limb size, which may suggest perinatal insult (Nowacki & Jirsh, 2017). Besides, dystonic posturing, such as the patient walking on the side of his feet, should also be examined, as it could be an indicator of injury on the corticospinal tracts.

Lab or Radiology Tests

The lab or radiology tests are determined after narrowing down the types of seizures during physical exanimation. However, first-time seizure patients will require extensive examination that range from blood tests and liver function assessment. Blood test is vital to check for genetic diseases, infections, or other conditions that may trigger seizures. Based on the disorders suspected clinically, particular tests may be the priority. If one suspects CNS infection or meningitis, normal neuroimaging test should be conducted to show the lumber picture (Nowacki & Jirsh, 2017). Neuroimaging is done by means of Computerized Tomography (CT) scan and a Magnetic Resonance Imaging (MRI). CT scan makes use of X-ray to show cross-section areas of the brain and reveals abnormalities, such as bleeding, cysts, and tumors. MRI creates a detailed view of the brain based on the use of strong magnets and radio waves to spot abnormalities and lesions. However, these two scans are rather expensive and can hardly be afforded by personal funding. Notably, since the patient has no insurance, an electroencephalogram (EEG) test is best advised. An EEG records brain electrical activity and brain waves that allows one to narrow down the type of seizures and eliminate other conditions (Chen, 2018). In addition, this method is relatively cost favorable and can be used to diagnose the most common cause of seizures, epilepsy.

Therefore, the physician can conduct various tests on the patient to diagnose the cause of seizures. In the described case study, the patient should undergo through various physical and laboratory tests. The results are evaluated by the physician to determine the root cause of the seizure. However, as the patient does not have an insurance, there is a need to choose one test that would be effective and cheap, and it is electroencephalogram.