Epilepsy evaluation for patients from Pokhara
A first seizure, recurrent events or an existing epilepsy diagnosis that is not controlled needs a structured evaluation. Pokhara is a regional referral hub in western Nepal. Patients often travel six to seven hours by road or take a short flight, so the first visit is planned as one comprehensive assessment.
The history is the most important part of the assessment: what happened before, during and after the event, how long it lasted, whether there was confusion or injury, and what witnesses observed. A video recording, if it can be captured safely, is often more useful than a description alone.
- First seizure or a suspected seizure
- Recurrent events with uncertainty about the diagnosis
- Epilepsy that is not controlled on current medication
- Medication side effects or a planned pregnancy
- Seizures after stroke, head injury or brain infection
Related: Neurology → · Dr. Jitendra Knowledge Hub → · ICHD-3 Topic →
Planning the visit from Pokhara
By road, follow the Prithvi Highway from Pokhara to Kathmandu (roughly 200 km, 6-7 hours depending on conditions). By air, fly to Kathmandu and continue by taxi to Durbar Marg.
Bring witness accounts, any videos, a seizure diary, medication history with doses, and prior EEG or MRI reports. The clinic is at Durbar Marg, Opposite of Yak & Yeti Hotel. If the patient cannot travel safely alone, a companion should accompany them.
- Witness description or a safely captured video
- Seizure diary with dates, duration and recovery
- Current and previous antiseizure medicines with doses
- Prior EEG, MRI and blood test reports
Diagnosis and treatment
EEG helps classify seizure type and may show epileptiform activity; MRI is considered when a structural cause is suspected. Not every first seizure is epilepsy, and provoked causes such as infection, metabolic disturbance, alcohol withdrawal or medication effects must be excluded.
Treatment decisions balance seizure control, medication side effects, lifestyle and pregnancy plans. Safety counselling covers sleep, alcohol, driving, bathing and swimming, and when a rescue medication plan is appropriate.
| Question | What it helps decide |
|---|---|
| Was the event a seizure? | Whether EEG or MRI is needed |
| What type of seizure? | Which medication is appropriate |
| What triggered it? | Whether it is provoked or unprovoked |
| What is the safety plan? | Driving, work, bathing and rescue medication |
When urgent care is needed
A seizure lasting more than five minutes, repeated seizures without recovery, injury, breathing difficulty, or a first seizure with fever and neck stiffness is an emergency. Go to the nearest emergency department rather than waiting for a clinic appointment.
- Seizure lasting more than five minutes
- Repeated seizures without regaining consciousness
- Injury, breathing difficulty or a seizure in water
- First seizure with fever, neck stiffness or pregnancy