Which tests are typically included in the workup for a new onset seizure?

The workup for a new onset seizure should include tests that help evaluate the underlying causes of the seizure activity. The inclusion of a complete blood count (CBC) is important as it can identify infection, anemia, or other hematologic disorders. A comprehensive metabolic panel (CMP) can assess for electrolyte imbalances, renal function, and liver function, any of which could contribute to seizure activity.

Urine drug screening (UDS) is also necessary to rule out any substance use that could provoke seizures, such as recreational drugs or certain medications. An electroencephalogram (EEG) is critical for directly assessing the electrical activity of the brain and identifying any patterns consistent with seizures. Lastly, imaging studies such as an MRI are essential to visualize the brain for structural anomalies, tumors, or signs of trauma that might be related to the seizure disorder.

This comprehensive approach, combining blood tests, urine analysis, neurophysiological studies, and advanced imaging, allows clinicians to adequately assess and diagnose the reasons behind the patient’s new onset seizures, guiding subsequent management and treatment.