Materiały źródłowe

• #1 Seizure – Wikipedia

  https://en.wikipedia.org/wiki/Seizure

  A seizure is a sudden, brief disruption of brain activity caused by abnormal, excessive, or synchronous neuronal firing. […] Most seizures last less than two minutes and are followed by a postictal period of confusion, fatigue, or other symptoms. […] A seizure lasting longer than five minutes is a medical emergency known as status epilepticus. […] Seizures are classified as provoked, when triggered by a known cause such as fever, head trauma, or metabolic imbalance, or unprovoked, when no immediate trigger is identified. Recurrent unprovoked seizures define the neurological condition epilepsy. […] The clinical evaluation after a seizure event involves confirming if the episode was epileptic in nature, determining its type and cause, and distinguishing it from other conditions that can mimic seizures.

• #1 Epilepsy Exams and Tests: How is Epilepsy Diagnosed?

  https://www.webmd.com/epilepsy/diagnosing-epilepsy

  An epilepsy diagnosis takes patience. It isnt something that happens in one office visit. But if you stick with the process, your doctor can figure out if the disease is causing your seizures and treat it. […] Whether you have epilepsy depends on your symptoms before, during, and after a seizure. Since the doctor probably wont be there when you have one, theyll run a number of tests and ask many questions to reach a diagnosis. […] To figure out if you have epilepsy and what type you have, your doctor will do some or all of these tests: […] Electroencephalogram (EEG). This is the most common test. Your doctor places sensors on your scalp that record electrical activity in your brain. If they see changes in your normal brain wave pattern, thats a symptom. Many people with epilepsy have abnormal EEGs.

• #1 Epilepsy and Seizures Differential Diagnoses

  https://emedicine.medscape.com/article/1184846-differential

  The diagnosis of seizures is based on the patients clinical history. The history as related by a witness is of high importance, because many types of seizures are associated with impairment of consciousness, and patients are unaware of their occurrence. […] The clinical diagnosis can be confirmed by abnormalities on the interictal electroencephalogram (EEG). However, these abnormalities can be present in otherwise healthy individuals, and their absence does not exclude the diagnosis of epilepsy.

• #1 Clinical Aspects of the Diagnosis of Epileptic Seizures and Epileptic Syndromes – The Epilepsies – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2609/

  Patients with epileptic seizures and their families are entitled to a diagnosis, prognosis and management that are specific and precise. […] Effective classification of epileptic seizures and syndromes is indispensable for appropriate management and prognosis. […] There are three important diagnostic steps towards this aim. […] The first step towards the correct diagnosis of epilepsies is to establish whether a paroxysmal clinical event was actually an epileptic seizure or something else. […] Misdiagnosis in epilepsies, when considering its dimensions and consequences, is a colossal medical problem. […] The differentiation between seizures and other causes of transient neurological disturbance and collapse is epitomised by the familiar theme fits, faints and funny turns. […] The presence or absence of a single symptom is not sufficiently diagnostic of one or another disease and may be misleading.

• #1 Diagnosis – Epilepsy Ontario

  https://epilepsyontario.org/about-epilepsy/diagnosis/

  If you think you had a seizure-like episode, this is the place to be. From the first seizure to possible treatments, this section walks you through the steps you may take to determine whether or not you have epilepsy. […] Seizures may have many different appearances, which can be difficult to recognize. Some of the following may be indications that a seizure is occurring. Look for and make note of particular patterns of behaviour if they occur too often to be attributed to chance. […] Physicians use Electroencephalogram (EEG) recordings to accurately diagnose the condition. […] If you suspect you may have had a potential seizure, meeting with your physician is a good place to start. […] A physician or nurse practitioner will ask questions about the seizure episode(s), including what happened before, during and after the seizure(s).

• #1 Epilepsy

  https://www.nhs.uk/conditions/epilepsy/

  If you or your child have had a seizure you’ll need to see a specialist doctor. They’ll check what caused it and whether you might have epilepsy. […] Tests you might have include: an electroencephalogram (EEG) to check electrical activity in your brain, an electrocardiogram (ECG) to check your heart, scans such as an MRI scan or CT scan, blood tests, genetic testing. […] Having a seizure does not always mean you have epilepsy, as seizures can have other causes. You’ll usually be diagnosed with epilepsy if you’ve had more than 1 seizure, or if tests show you’re at risk of having more seizures.

• #1 Diagnosing Epilepsy – Tests and Tools

  https://www.cureepilepsy.org/understanding-epilepsy/diagnosing-epilepsy/tests-tools/

  Looking at images of the brain and monitoring the electrical activity with long-term video-EEG monitoring at an epilepsy monitoring unit (EMU) may help doctors in diagnosing and treating your epilepsy. […] The electroencephalogram (EEG) is the most common diagnostic test in epilepsy. It is a non-invasive, painless test which monitors the electrical activity in your brain (brain waves). When a patient has a seizure during an EEG, their brain waves change, and the EEG can detect the abnormality. […] If the technologist does not get a good picture of the persons brainwaves with a routine EEG, the person may be referred to an EMU for more detailed monitoring. […] Neuropsychological tests help understand the extent and impact of these effects. […] Using this technique, the physician may be able to see brain tumors or bleeding that could be causing seizures.

• #1 Seizures – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seizure/diagnosis-treatment/drc-20365730

  EEG results show changes in brain activity. This may help diagnose brain conditions such as epilepsy and other seizure conditions. […] After a seizure, your healthcare professional reviews your symptoms and medical history and does a physical exam. You may have tests to find the cause of your seizure. Tests also may show how likely it is that you’ll have another seizure. […] A healthcare professional also may do a type of SPECT test called subtraction ictal SPECT coregistered with MRI (SISCOM). The test may give results with even more detail. This test is usually done in a hospital with overnight EEG recording. […] The goal in seizure treatment is to find the best therapy that stops seizures with the fewest side effects. […] Treatment of seizures often involves antiseizure medicines. There are many types of antiseizure medicine.

• #1 Seizure Disorders – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/seizure-disorders/seizure-disorders

  Electroencephalography (EEG) is critical in the diagnosis of epileptic seizures, particularly of focal impaired-awareness seizures or absence status epilepticus, when EEG may be the most definitive indication of a seizure. EEG may detect epileptiform abnormalities (spikes, sharp waves, spike and slow-wave complexes, polyspike and slow-wave complexes). […] EEG findings may include the following: Epileptiform abnormalities in temporal lobe foci between seizures (interictal) in focal impaired-awareness seizures originating in the temporal lobe. […] However, normal EEG cannot exclude the diagnosis of epileptic seizures, which must be made clinically. EEG is less likely to detect abnormalities if seizures are infrequent. The initial EEG may detect an epileptiform abnormality in only 30 to 55% of patients with a known epileptic seizure disorder. […] Inpatient combined video-EEG monitoring, usually for 2 to 7 days, records EEG activity and clinical behavior simultaneously. It is the most sensitive EEG testing available and is thus useful in differentiating epileptic from nonepileptic seizures.

• #1 Electroencephalography (EEG) in the diagnosis of seizures and epilepsy – UpToDate

  https://www.uptodate.com/contents/electroencephalography-eeg-in-the-diagnosis-of-seizures-and-epilepsy

  Electroencephalography (EEG) in the diagnosis of seizures and epilepsy […] The diagnosis of epilepsy is often not straightforward, and misdiagnosis is not rare. A detailed and reliable account of the event by an eyewitness is the most important part of the diagnostic evaluation, but may not be available. […] This topic discusses the use of EEG in the diagnosis of seizures and epilepsy. The use of other diagnostic tests in the evaluation of patients with seizures and epilepsy are presented separately. […] Electroencephalography (EEG) is an important diagnostic test in evaluating a patient with possible epilepsy. It can provide support for the diagnosis of epilepsy and also assists in classifying the underlying epileptic syndrome. […] However, there are several reasons why EEG alone cannot be used to make or refute a specific diagnosis of epilepsy: Most EEG patterns can be caused by a wide variety of different neurologic diseases.

• #1 Diagnosing Epilepsy & Seizure Disorders | NYU Langone Health

  https://nyulangone.org/conditions/epilepsy-seizure-disorders/diagnosis

  A doctor also uses other diagnostic tools, including the following, to determine if a person has epilepsy. […] This exam can help doctors determine whether brain function is impaired. […] If a doctor suspects epilepsy is causing your symptoms, he or she may order an electroencephalography, or EEG. This tool is the most specific test for diagnosing epilepsy because it records the electrical activity of the brain. […] Sometimes the results of a routine EEG are normal or reveal only minor, nonspecific findings. […] Video EEG monitoring allows the doctor to view your behavior and brain activity. […] A doctor may order an MRI scanin which a magnetic field and radio waves create computerized two- or three-dimensional imagesto better view the structure of the brain. […] A CT scan is a type of X-ray that creates detailed images of tissue and internal organs.

• #1 Diagnosing Epilepsy – Tests and Tools

  https://www.cureepilepsy.org/understanding-epilepsy/diagnosing-epilepsy/tests-tools/

  MRIs, along with other tests, can be used to pinpoint the diagnosis of a persons epilepsy and is extremely useful if there is structural damage (or lesion) contributing to seizures. […] Therefore, genetic testing may be performed on a patient with epilepsy to determine if there is a genetic variation that could explain their epilepsy.

• #1 Epilepsy Diagnosis – How, where and who diagnoses Epilepsy

  https://www.cureepilepsy.org/understanding-epilepsy/diagnosing-epilepsy/how-is-epilepsy-diagnosed/

  A CT scan is often used in emergency situations to identify any potential brain injuries or bleeding that could trigger seizures. […] Although blood tests do not directly diagnose epilepsy, they help rule out other potential causes of seizures, such as infections, metabolic disorders, or genetic conditions. […] Neuropsychological tests assess cognitive and memory functions. They can provide insight into how epilepsy affects brain function, which is particularly useful for tailoring treatment plans. […] Epilepsy can be diagnosed by a variety of medical professionals in various medical settings, ranging from doctors in the emergency room to epileptologists in an epilepsy monitoring unit (EMU). […] If a person’s seizures are not controlled after three months of treatment by a PCP, or after 12 months of treatment by a neurologist, they should be referred to an Epilepsy Center.

• #1 Epilepsy Diagnosis and Evaluation Services – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/neurosciences-center/epilepsy-and-seizure-disorders/diagnosis-evaluation-presurgical-planning?TRILIBIS_EMULATOR_UA=nsclpd

  EEG with polysomnography: This is a complete EEG conducted along with a simultaneous sleep study that provides overnight epilepsy monitoring and measures various parameters of sleep cycles and stages of sleep. […] Intracranial EEG monitoring: This is an invasive procedure that provides the most precise information available regarding seizure location, when routine scalp EEG monitoring is unable to localize the seizure focus for those patients interested in pursuing surgery as treatment for epilepsy. […] Functional magnetic resonance imaging (fMRI), diffusion, diffusion tensor imaging (DTI), magnetoencephalography (MEG) and ictal SPECT, are used together to noninvasively localize seizure activity and identify areas of the cortex of the brain that are related to critical function, including language, motor skills and memory.

• #1 Epilepsy Diagnosis and Evaluation Services – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/neurosciences-center/epilepsy-and-seizure-disorders/diagnosis-evaluation-presurgical-planning?TRILIBIS_EMULATOR_UA=nsclpd

  A Positron Emission Tomography (PET) scan allows specialists to see changes in brain metabolism using the uptake of glucose with a radioactive atom in it. A PET scan is used to identify areas of hypometabolism (decreased glucose uptake), which may be associated with a seizure. […] Wada Testing: Named after Juhn Wada, a Japanese-Canadian neurologist, this test is used to determine which side of the brain is most responsible for language and short-term memory.

• #1 Diagnosing Epilepsy & Seizure Disorders | NYU Langone Health

  https://nyulangone.org/conditions/epilepsy-seizure-disorders/diagnosis

  Single-photon emission CT (SPECT) is an imaging tool that reveals blood flow in the brain. […] A PET scan uses small amounts of radioactive glucose, or sugar, is injected intravenously to create a detailed image of the brain. […] Magnetic resonance spectroscopy uses an MRI machine to analyze the molecular components of tissue in a particular area of the brain. […] Functional MRI uses a standard MRI machine to measure changes in oxygen and blood flow to a particular area of the brain while a person performs specific tasks. […] Magnetoencephalography is an imaging technique used to identify and analyze brain activity.

• #1 Evaluation of a First Seizure | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0501/p1342.html

  Electroencephalography is recommended for patients presenting with a first seizure. […] Neuroimaging should be performed in children with a postictal focal neurologic deficit that does not resolve or in children who do not return to baseline neurologic function within several hours. […] Neuroimaging scans reveal abnormalities in 3 to 38 percent of patients with a first seizure, depending on patient demographics. […] The decision to initiate treatment after a single unprovoked seizure is controversial. […] ACEP policy states that patients evaluated in the emergency department for a seizure who have a normal neurologic examination, no known comorbidities, and no known structural brain abnormalities may be referred for outpatient follow-up without initiating an antiepileptic medication.

• #1 Seizures: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/neuro/seizures/treatment

  How Are Seizures Diagnosed? Diagnosis If you think youve experienced a seizure, certain tests and methods can help determine the cause and the probability of recurrence. A health care provider, typically a neurologist, will first inquire about your health history and details about your seizure. Your doctor may perform the following: Neurological exam, during which your health care provider may test motor skills and mental functions, and inquire about your emotional state […] Electroencephalogram (EEG), during which a technician will attach electrodes (pads) to your head to monitor electrical brain activity […] Imaging tests, including a computerized tomography (CT) scan, followed by a magnetic resonance imaging (MRI) scan of the brain, and, if necessary, a positron emission tomography (PET) scan of the brain. These tests can spot lesions (structural abnormalities) such as bleeding, tumors, developmental malformations, or other abnormalities in the brain that can cause seizures

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Epileptic-Seizure-Diagnosis.aspx

  Blood tests may be performed to rule out hypoglycemia, hypoxia, or withdrawal from addictive substances such as alcohol or sedatives. […] The brain may be monitored using an electroencephalogram (EEG) to check for abnormal patterns of electrical activity that may indicate epilepsy. […] A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan may be used to create pictures of the brain to reveal any physical damage that could be causing epilepsy.

• #1 Diagnosing Pediatric Epilepsy: Diagnostic Tests

  https://www.aap.org/en/patient-care/epilepsy/diagnosing-pediatric-epilepsy/diagnosing-pediatric-epilepsy-diagnostic-tests/?srsltid=AfmBOoqvkqapUDG4WgOCD7mi6LK43wU6vEWa911ANO37SpuVx-flVYOL

  Epilepsy can be diagnosed when an individual has had two seizures without a clear provoking cause or one seizure with a high risk of having more seizures. A physician taking care of an individual who had an event concerning for a seizure will use information from the individuals medical history as well as the results of diagnostic tests to determine what type of seizures and what type of epilepsy that individual has. Early identification of the type of seizures and the type of epilepsy is important as it often influences treatment decisions and long-term prognosis. […] An electroencephalogram (EEG) is a test that measures the electrical activity in the brain. It can help determine what type of seizures or epilepsy a person has and if seizures are coming from one area of the brain. […] Neuroimaging refers to tests that take pictures of the brain to identify any changes in the brains structure that could explain why a person may have had a seizure. […] Genetic tests look for changes in how a persons body was programmed to develop that could make them more likely to have epilepsy.

• #1 Epilepsy Diagnosis – Initial & Surgical Evaluation, Second Opinions

  https://www.dukehealth.org/treatments/neurological-disorders/epilepsy-diagnosis

  Neurogenetic Testing can help inform doctors whether your epilepsy is genetic, which can affect your treatment plan. […] If your initial evaluation results indicate that you may be a candidate for epilepsy surgery, you will need to undergo some additional testing or surgical procedures to pinpoint your seizure focus. […] Functional MRI (Magnetic Resonance Imaging) detects brain areas involved in particular functions and detects changes in blood flow in the brain. […] DTI (Diffusion Tensor Imaging) focuses on brain anatomy and enables doctors to examine complex microstructures in the brain and identify small abnormalities. […] PET (Positron Emission Tomography) investigates chemical activity and shows brain metabolism, highlighting areas of the brain where seizures begin. […] High-Density EEG and ESI (Electrical Source Imaging) provide more information about where the seizures start and how they spread.

• #1 Diagnosing Epilepsy – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/neurology-neurosurgery/epilepsy-seizures/screening-diagnosis

  At UChicago Medicine, we offer various structural and functional neuroimaging studies to help diagnose epilepsy and localize the seizure focus. These tests include high-resolution brain magnetic imaging (MRI), functional MRI (fMRI) and positron emission tomography (PET). […] MEG is a new technique for mapping brain activity by recording magnetic fields produced by electrical currents that occur naturally in the brain using very sensitive magnetometers. Since magnetic fields are less distorted than electrical fields by the skull and scalp, MEG has a better spatial resolution than EEG in detecting and localizing seizure activity in some patients with epilepsy. […] Epilepsy patients who are candidates for surgery may undergo a Wada test. A neuroradiologist performs the procedure in the presence of a neuropsychologist and a neurologist. The Wada test helps determine which side of the brain controls language and memory capacity of each side of the brain. This information is important for planning epilepsy surgery and minimizing the risks of language and memory deficits. With the development of more sophisticated functional MRI techniques, the Wada test can now often be avoided.

• #1 Epilepsy Diagnosis – Initial & Surgical Evaluation, Second Opinions

  https://www.dukehealth.org/treatments/neurological-disorders/epilepsy-diagnosis

  Neuropsychological Testing helps doctors determine which parts of your brain might not be functioning normally. […] Robot-Assisted Stereoelectroencephalography (SEEG) is used to pinpoint where a seizure starts. […] Subdural Electrodes are used when the seizure focus is difficult to pinpoint. […] Brain Mapping identifies vital areas in your brain responsible for movement, sensation, language, and vision. […] Wada Test is used to determine vital brain functions on the left versus right side of the brain. […] As a Level 4 Epilepsy Center, Duke Health provides the highest level of diagnosis, medical, and surgical treatments for people with epilepsy.

• #1 Epilepsy: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17636-epilepsy

  Tests include: Electroencephalography (EEG): This test measures the electrical activity in your brain. Certain abnormal electrical patterns are related to seizures. […] Treatments to control epilepsy include anti-seizure medications, special diets (usually in addition to anti-seizure medications) and surgery. […] Anti-seizure medications can control seizures in about 60% to 70% of people with epilepsy. Anti-seizure medication treatment is individualized. […] If anti-seizure medications dont control your seizures, your healthcare provider will discuss other treatment options, including special diets, medical devices or surgery. […] Your healthcare provider will consider surgery if anti-seizure medications dont control your seizures, and if your seizures are severe and debilitating. Epilepsy surgery can be a safe and effective treatment option when more than two anti-seizure medication trials fail to control your seizures. […] About 70% of people become seizure-free with proper treatment within a few years. The remaining 30% are considered to have drug-resistant epilepsy. These people should go to an epilepsy center to determine if theyre candidates for epilepsy surgery.

• #1 The Diagnosis of Functional Seizures

  https://practicalneurology.com/diseases-diagnoses/epilepsy-seizures/the-diagnosis-of-functional-seizures/31887/

  VideoEEG in the context of a complete clinical picture remains the gold standard for diagnosis of functional seizures. […] FS can also be considered dissociative. […] The average diagnostic delay for FS is 7 to 10 years, which means patients carry an erroneous diagnosis of epilepsy, often considered drug-resistant, for a long period of time. […] It is important to have a high degree of suspicion for nonepileptic events to avoid the misdiagnosis of epilepsy. […] Diagnosis of FS can be suspected based on the history, making accurate history from witnesses among the most important initial pieces of the puzzle. […] VideoEEG monitoring is based on the principle that FS lack ictal epileptiform discharges. […] To evaluate FS, the physician ideally should be able to look at the semiology of an event or events and analyze the EEG.

• #1 Epilepsy and Seizures: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1184846-overview

  Epilepsy is defined as a brain disorder characterized by an enduring predisposition to generate epileptic seizures and by the neurobiologic, cognitive, psychological, and social consequences of this condition. […] The diagnosis of epileptic seizures is made by analyzing the patient’s detailed clinical history and by performing ancillary tests for confirmation. […] Potentially useful laboratory tests for patients with suspected epileptic seizures include the following: Prolactin levels obtained shortly after a seizure to assess the etiology (epileptic vs nonepileptic) of a spell; levels are typically elevated 3- or 4-fold and more likely to occur with generalized tonic-clonic seizures than with other seizure types; however, the considerable variability of prolactin levels has precluded their routine clinical use.

• #1 EPILEPSY CLASSIFICATION

  https://www.epilepsydiagnosis.org/epilepsy/epilepsy-classification-groupoverview.html

  Epilepsy is a disease of the brain defined by any of the following conditions: […] Diagnosis of an epilepsy syndrome. […] Epilepsy classification is undertaken after the criteria for diagnosing epilepsy are met (definition above). Classification is undertaken using a multi-level classification framework, involving classification at three levels – the seizure type, epilepsy type and epilepsy syndrome. Imaging, EEG and other investigations, where available, contribute to optimized classification at all three levels. Where possible, a diagnosis at all three levels should be established. The etiology of the epilepsy should be considered from the outset, and at each step along the diagnostic pathway. Knowing the etiology can inform optimized classification and has important treatment implications for the patient. […] Epilepsies are classified as: generalized epilepsy, focal epilepsy, combined generalized and focal epilepsy, unknown epilepsy.

• #1 Seizure – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430765/

  Status epilepticus is defined as an enduring epileptic condition. […] Seizures may be either provoked or unprovoked. […] By definition, unprovoked seizures occur in the absence of provocative causes or more than seven days after an acute injury or insult such as stroke or brain hemorrhage. […] Electroencephalography (EEG) is a biomarker for epilepsy. […] Persistent alteration of consciousness or continuing seizures will dictate additional testing such as neuroimaging and other serologic tests. […] A first unprovoked seizure in an adult who has returned to a normal neurological baseline often does not require initiation of medical treatment. […] If deciding to start drug therapy, many medications are options to treat a chronic seizure disorder or epilepsy as first-line medication or adjunctive medications.

• #1 Clinical Aspects of the Diagnosis of Epileptic Seizures and Epileptic Syndromes – The Epilepsies – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2609/

  The significance of the EEG and its optimal use in the diagnosis of the epilepsies is detailed in Chapter 2. […] Having established that a paroxysmal event is genuinely epileptic, the next step, not the final step, is to define the type of seizure or seizures, which is a prerequisite for the correct diagnosis and management. […] Minor seizures should be thoroughly sought during the clinical evaluation. […] The standardised classification and terminology for epileptic seizures and syndromes by the ILAE provides a fundamental framework for organising and differentiating them. […] The currently valid ILAE seizure classification of 1981 is an old updated version of the classification proposed by Gastaut in 1970. […] The description and definitions of epileptic seizures and syndromes in this chapter are based entirely on the currently valid ILEA proposals. […] The significance of the syndromic diagnosis of epilepsies has been emphasised on many occasions. […] Accurate diagnosis is the golden rule in medicine and epilepsies should not be an exception to this.

• #1 Seizure – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430765/

  A seizure represents the uncontrolled, abnormal electrical activity of the brain that may cause changes in the level of consciousness, behavior, memory, or feelings. […] Seizures can classify as partial or generalized. […] This activity examines when this condition should be a consideration on differential diagnosis and how to evaluate it properly. […] An epileptic seizure is a transient occurrence with signs or symptoms due to abnormal excessive and synchronous neuronal activity in the brain. […] Current classification designates two large categories – partial or generalized. […] Determining whether a first seizure or recurrent seizures are provoked or unprovoked is fundamentally essential for diagnosis and treatment. […] Epileptic syndromes serve to condense clinical information into useful nomenclature.

• #1

• #1 Seizure: What It Is, Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/22789-seizure

  A healthcare provider will offer regular follow-up appointments after you start taking a new medication to measure its effectiveness. […] Studies show that an estimated 33% of people who take antiseizure medications notice that seizure symptoms completely stop. Another 33% say they see less frequent symptoms after taking antiseizure medications. […] Seizures are unpredictable, so it’s not possible to completely prevent them. The best thing you can do is avoid possible causes or triggers, like managing blood glucose levels or protecting yourself from illness and injury. […] Fewer than half of people who have a single, unprovoked seizure will have another. If a second seizure happens, healthcare providers may recommend starting antiseizure medications. […] If seizures happen often, your provider can help you take precautions to stay safe. You may choose to wear a medical ID bracelet or carry a medical ID card with you so others will know what to do in the event of a seizure.

• #1

  https://www.who.int/news-room/fact-sheets/detail/epilepsy

  Epilepsy is defined as having two or more unprovoked seizures. […] Seizures can be controlled. Up to 70% of people living with epilepsy could become seizure free with appropriate use of antiseizure medicines. […] A documented etiology of the seizure and an abnormal electroencephalography (EEG) pattern are the two most consistent predictors of seizure recurrence. […] It is possible to diagnose and treat most people with epilepsy at the primary health-care level without the use of sophisticated equipment. […] WHO pilot projects have indicated that training primary health-care providers to diagnose and treat epilepsy can effectively reduce the epilepsy treatment gap.

• #1 Clinical Aspects of the Diagnosis of Epileptic Seizures and Epileptic Syndromes – The Epilepsies – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2609/

  Paroxysmal nonepileptic events misdiagnosed as epileptic seizures affect as many as 20-30% of patients diagnosed and often treated for many years as epilepsy or admitted in tertiary care epilepsy units. […] The physiological or organic nonepileptic seizures are a broad spectrum of episodic manifestations ranging from normal phenomena such as hypnagogic jerks, hallucinations or illusions to a galaxy of abnormal paroxysmal symptoms of a variety of brain and systemic disorders. […] The diagnosis of epileptic and nonepileptic seizures is almost always based solely on the clinical history, which should be masterly obtained, often requiring lengthy interrogation(s) of the patient and witnesses. […] In taking the medical history, every piece of information should be patiently gathered in order to assess the whole pattern of these transient events from the time that these started to their end and up to normality.

• #1 EEG tests for epilepsy – Epilepsy Action

  https://www.epilepsy.org.uk/info/diagnosis/eeg-electroencephalogram

  Many people with epilepsy only have unusual electrical activity in their brain when they are having a seizure. […] People with some types of epilepsy have unusual electrical activity in their brain even when they are not having a seizure. […] A small number of people have unusual EEG test results, even though they never have seizures and they dont have epilepsy. […] When an EEG test picks up unusual electrical activity, the doctor will look at where it is happening in the brain. […] An EEG test only gives information about the electrical activity in your brain. It can show if there is unusual electrical activity but it does not show if there are any physical abnormalities of the brain. […] There are several ways to do an EEG test. And there are several reasons why you might be asked to have more EEGs.

• #1 Tests and Investigation | Epilepsy FoundationFacebookInstagramTwitterPhoneEmailFacebookInstagramTwitter

  https://epilepsyfoundation.org.au/understanding-epilepsy/diagnosing-epilepsy/testing-and-investigation/

  People sometimes think that imaging tests such as an EEG, CT scan or an MRI will determine that they have had a seizure. However, information from tests alone can’t always confirm that a seizure has occurred, or that the person has epilepsy. […] An EEG examines electrical activity in the brain. However, electrical changes are often only seen during a seizure. This means that when an EEG comes back normal, it could simply indicate that seizure activity was not occurring when the test was taken – it doesn’t mean that a seizure has not occurred at another time. An abnormal EEG can suggest that a person is more likely to have seizures which can be helpful to the doctor during the diagnosis period. However, an EEG can be abnormal for a variety of reasons unrelated to seizures. […] MRI and CT scans show how a person’s brain is structured and, sometimes, a possible cause for seizure activity can be seen on a scan. This may be small changes in how the brain tissue developed, blood vessel changes, or changes as a result of a tumour or traumatic brain injury. But, just like an EEG, the scans can show up as being normal in people who have had a witnessed or suspected seizure. It is also possible for a person to have an ‘abnormal’ CT or MRI and not have a diagnosis of epilepsy.

• #1 Diagnosing Epilepsy – Tests and Tools

  https://www.cureepilepsy.org/understanding-epilepsy/diagnosing-epilepsy/tests-tools/

  The first step in this diagnostic journey is to confirm that the person is indeed experiencing epilepsy. Once this is done, the doctor investigates the type of seizures, where they originate in the brain, and whether the seizures are a feature of an epilepsy syndrome. […] Getting an epilepsy diagnosis can take time, especially if the seizures are infrequent or are subtle like a staring spell. It is critical to identify the type(s) of seizures one is experiencing to receive an accurate diagnosis. […] The diagnostic process includes tests such as electroencephalogram (EEG), computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, and blood tests to investigate genetic mutations. […] Therefore, the doctor will spend some time and take a detailed medical history and ask questions about what the person was doing and feeling before, during, and after the seizure.

• #1 Diagnosis – Epilepsy Action

  https://www.epilepsy.org.uk/info/diagnosis

  About 20 in 100 people (20%) diagnosed with epilepsy are wrongly diagnosed. […] Its also possible to be wrongly diagnosed with another condition. […] There is no single test that can confirm epilepsy. […] Test results may be misunderstood. […] Your symptoms and medical history are not taken accurately. […] If you think your symptoms have been misdiagnosed, it may be worth asking your specialist to go through your diagnosis with you.

• #1 EEG tests for epilepsy – Epilepsy Action

  https://www.epilepsy.org.uk/info/diagnosis/eeg-electroencephalogram

  An electroencephalogram (EEG) is a common test used to help diagnose epilepsy, and to find out more about someones seizures. […] A highly trained specialist, called a clinical neurophysiologist will look at your results. They can recognise if your EEG test shows a brainwave pattern that is unusual. Some of these patterns point to a strong possibility of epilepsy. […] The results of an EEG can help doctors to make the correct diagnosis and decide on the best treatment. A doctor who specialises in reading EEG results should interpret them. This is because reading an EEG incorrectly is one of the most common reasons for people to be given the wrong diagnosis. […] An EEG test gives information about the electrical activity that is happening in your brain at the time the test is carried out.

• #1 Testing for Epilepsy: Getting an Epilepsy Diagnosis

  https://www.health.com/epilepsy-diagnosis-7107057

  A proper diagnosis can help your healthcare provider understand the best course of treatment for your condition. They can help you manage your symptoms and prevent complications. […] A neurologist can use your medical history and several tests to determine the type of seizures and form of epilepsy you have. […] To determine the epilepsy type, a neurologist will use an electroencephalograph (EEG). […] Even if you do not have a seizure during an EEG, the test can show signs of unusual electrical activity. […] The major types of epilepsy and their symptoms include: […] A genetic test for epilepsy is a type of blood test that can check whether you have certain genes commonly associated with different types of epilepsy. […] Aside from an EEG, there are other types of brain imaging tests and scans that can help diagnose epilepsy and monitor your brain function.

• #1 The Diagnosis of Functional Seizures

  https://practicalneurology.com/diseases-diagnoses/epilepsy-seizures/the-diagnosis-of-functional-seizures/31887/

  Therefore, just like any disorder with a psychiatric basis, FS deserve recognition as a psychiatric diagnosis to ensure that patients receive appropriate management. […] FS can be suspected based on history but should be confirmed with video-EEG monitoring, which also helps in ruling out coexisting epilepsy.

• #1 Seizure – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430765/

  For the patient with generalized convulsive status epilepticus, immediate treatment of the seizures should begin while stabilization and other diagnostic procedures commence. […] The prognosis of a patient with a single unprovoked seizure has been well delineated. […] The prognosis of patients with seizures depends mostly on any underlying cause. […] Common complications may include traumatic injuries such as tongue lacerations or scalp lacerations. […] Most generalized seizures terminate in less than five minutes, and a seizure of longer duration or serial seizures without regaining full consciousness in between defines status epilepticus.

• #1 Focal seizures – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/544

  Key diagnostic factors include movement of one side of the body or one specific body part, premonitory sensation or experience, automatisms, temporary aphasia, and staring and being unaware of surroundings. […] The first tests to order include blood glucose, CBC, electrolyte panel, toxicology screen, lumbar puncture and cerebrospinal fluid analysis, CT head, MRI brain, and electroencephalogram (EEG). […] When at least two monotherapy trials fail to achieve seizure remission, dual therapy may be tried; use of drugs with different mechanisms of action should be considered to maximize efficacy and minimize toxicity. […] Patients in whom seizure remission is not achieved with two monotherapy trials followed by dual therapy are considered to have refractory focal seizures. They should be evaluated to confirm the diagnosis and for consideration of resective epilepsy surgery and/or neuromodulation therapies.

• #1 Childhood Epilepsy: Diagnosis

  https://www.massgeneral.org/children/epilepsy/education/diagnosis

  The most important and commonly used tools are the electroencephalogram (EEG), computed tomography (CT) scans, and magnetic resonance imaging (MRI). […] The EEG is a safe and painless procedure that provides direct evidence of abnormalities associated with epilepsy. […] By assessing these patterns, doctors can in most cases identify specific seizure types and can locate the seizure origin, or focus, in partial seizures. […] The video EEG provides simultaneous recording of video and electrical activity in the brain. […] CT scans help doctors identify brain abnormalities commonly associated with seizures. […] MRI produces images of the internal structures of the brain with far more detail than CT scans reveal. […] Early diagnosis and treatment can make a tremendous difference in the developmental outcome for a child with epilepsy.

• #1 Childhood Epilepsy: Diagnosis

  https://www.massgeneral.org/children/epilepsy/education/diagnosis

  Diagnosing epilepsy relies on a variety of tools, techniques, and observations. […] Observations of the events, behaviors, and movements that lead up to, accompany, and follow a possible seizure are critical in determining whether or not the event is a seizure and, if so, the specific seizure type. […] Physicians typically ask individuals and their families a series of detailed questions about a seizure episode and the events leading up to it. […] The particular list of questions a physician poses following a child’s seizure will often vary from one case to the next. […] Physicians encourage those who have witnessed a seizure to write down all details about the event, before their memory of that event fades. […] The diagnosis of a single seizure would seem to suggest a potential course of evaluation and treatment.

• #1 Childhood Epilepsy: Diagnosis

  https://www.massgeneral.org/children/epilepsy/education/diagnosis

  To help with the accurate recording of seizure events, download a sample Seizure Journal and Seizure Diary (PDF). […] Seizures can be frightening and mysterious events for children and their families. […] A seizure is caused by an abnormal and excessive discharge of electrical activity in the brain usually accompanied by a change in behavior, sensation, or consciousness. […] Epilepsy is defined as the occurrence of two or more seizures that are not brought on by preventable causes, such as fever or low blood sugar. […] The process of diagnosing epilepsy can be very complex due to the variation in seizure types and their severity. […] Distinguishing between seizures and episodes that are not seizures is the first task of diagnosis because it guides the specific course of treatment.

• #1 Epilepsy Diagnosis | Boston Medical Center

  https://www.bmc.org/pediatrics-neurology/epilepsy/diagnosis

  Epilepsy is the 4th most common neurological disorder in the United States, and the 2nd most common among children. […] To reach a diagnosis, BMC physicians will need to collect the patients clinical history through interviews with the individual and their family. […] If you are able to bring a video recording of your childs seizure, this can be invaluable to the diagnostic process.

• #1 Diagnosis – Epilepsy 101 | Epilepsy Foundation of Metropolitan New York

  https://www.efmny.org/epilepsy-101-know-the-facts/diagnosis/

  Accurate diagnosis of a seizure disorder is critical in order to prescribe proper treatment, and obtain and maintain a healthy and productive lifestyle. Misdiagnosis can cause seizures to persist. The best way to diagnose epilepsy is through careful observation and documentation of symptoms, combined with a thorough medical examination, including evaluation of personal and family medical history, and appropriate neurological testing. […] A thorough medical examination including evaluation of personal and family medical history: An accurate personal history is very important, as well as family history. It is a good idea to check with older relatives about seizures in the family, as this information has sometimes been hidden in families. […] Appropriate neurological testing: The medical profession utilizes a variety of methods to diagnose epilepsy ranging from laboratory testing to imaging techniques.

• #1 EAWCP : Diagnosis & Treatment

  https://www.eawcp.org/epilepsy/diagnosis

  Giving the doctor as much information as possible will help the doctor to reach an accurate diagnosis. […] After a persons first seizure, they should see their doctor. The doctor will try to determine what might have caused the seizure, as well what types of treatment(s) might be appropriate. […] Finding out what type of seizures a person is having is the first step in finding a treatment to control them. […] While every diagnostic process will vary, the major steps in the process should include: a detailed and complete medical history, a detailed account of the seizure, and various medical tests. […] A persons medical history will be some of the most important information the doctor needs in reaching a diagnosis of epilepsy. […] Several kinds of medical test can be helpful in determining the diagnosis and treatment.

• #2 Seizure – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430765/

  A seizure represents the uncontrolled, abnormal electrical activity of the brain that may cause changes in the level of consciousness, behavior, memory, or feelings. […] Seizures can classify as partial or generalized. […] This activity examines when this condition should be a consideration on differential diagnosis and how to evaluate it properly. […] An epileptic seizure is a transient occurrence with signs or symptoms due to abnormal excessive and synchronous neuronal activity in the brain. […] Current classification designates two large categories – partial or generalized. […] Determining whether a first seizure or recurrent seizures are provoked or unprovoked is fundamentally essential for diagnosis and treatment. […] Epileptic syndromes serve to condense clinical information into useful nomenclature.

• #2 Diagnosis – Epilepsy Action

  https://www.epilepsy.org.uk/info/diagnosis

  Getting an epilepsy diagnosis can take time and your doctor may suggest having some tests. […] We explain how epilepsy is diagnosed and how to take care of yourself during this time. […] If you have a seizure, its important to see a doctor so they can find out why it happened. […] Having a seizure does not always mean that you have epilepsy. […] How long an epilepsy diagnosis will take depends on a few things, including where you live and what your symptoms are. […] There is no single test that can diagnose epilepsy. You will probably have a few medical tests. […] Your doctor will need to understand what your symptoms are and what happens when you have a seizure before they can diagnose epilepsy. […] Epilepsy should be diagnosed by a neurologist. […] Sometimes other things can look like and be mistaken for epileptic seizures.

• #2 Clinical Aspects of the Diagnosis of Epileptic Seizures and Epileptic Syndromes – The Epilepsies – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK2609/

  Paroxysmal nonepileptic events misdiagnosed as epileptic seizures affect as many as 20-30% of patients diagnosed and often treated for many years as epilepsy or admitted in tertiary care epilepsy units. […] The physiological or organic nonepileptic seizures are a broad spectrum of episodic manifestations ranging from normal phenomena such as hypnagogic jerks, hallucinations or illusions to a galaxy of abnormal paroxysmal symptoms of a variety of brain and systemic disorders. […] The diagnosis of epileptic and nonepileptic seizures is almost always based solely on the clinical history, which should be masterly obtained, often requiring lengthy interrogation(s) of the patient and witnesses. […] In taking the medical history, every piece of information should be patiently gathered in order to assess the whole pattern of these transient events from the time that these started to their end and up to normality.

• #2 Seizure Disorders – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/seizure-disorders/seizure-disorders

  Electroencephalography (EEG) is critical in the diagnosis of epileptic seizures, particularly of focal impaired-awareness seizures or absence status epilepticus, when EEG may be the most definitive indication of a seizure. EEG may detect epileptiform abnormalities (spikes, sharp waves, spike and slow-wave complexes, polyspike and slow-wave complexes). […] EEG findings may include the following: Epileptiform abnormalities in temporal lobe foci between seizures (interictal) in focal impaired-awareness seizures originating in the temporal lobe. […] However, normal EEG cannot exclude the diagnosis of epileptic seizures, which must be made clinically. EEG is less likely to detect abnormalities if seizures are infrequent. The initial EEG may detect an epileptiform abnormality in only 30 to 55% of patients with a known epileptic seizure disorder. […] Inpatient combined video-EEG monitoring, usually for 2 to 7 days, records EEG activity and clinical behavior simultaneously. It is the most sensitive EEG testing available and is thus useful in differentiating epileptic from nonepileptic seizures.

• #2 Epilepsy Testing Methods | University of Utah Health

  https://healthcare.utah.edu/neurosciences/neurology/epilepsy/tests

  At your first appointment, your doctor will review your epilepsy symptoms and medical history. He or she will use different tests to pinpoint the cause and location of your seizures. […] Initial testing for epilepsy at your appointment may include: a neurological exam where the doctor tests things like motor skills, mental function, and behavior or blood tests to check for things like infection or genetic conditions that could be associated with your seizures. […] Once these initial tests are complete, your doctor may recommend one or more of the following tests: Electroencelphalograms (EEGs), Long-term monitoring EEG unit, Imaging scans, Neuropsychological evaluation, Wada testing, Intracranial monitoring. […] Electroencephalograms are the most common diagnostic test for epilepsy. During the test, you will have electrodes attached to your scalp — either directly or with a cap. These electrodes will watch and record the electrical activity inside your brain. If you have epilepsy, your EEG test results may show abnormalities in your brain wave patterns. These abnormalities may occur even when you’re not experiencing a seizure.

• #2 The Diagnosis of Functional Seizures

  https://practicalneurology.com/diseases-diagnoses/epilepsy-seizures/the-diagnosis-of-functional-seizures/31887/

  VideoEEG in the context of a complete clinical picture remains the gold standard for diagnosis of functional seizures. […] FS can also be considered dissociative. […] The average diagnostic delay for FS is 7 to 10 years, which means patients carry an erroneous diagnosis of epilepsy, often considered drug-resistant, for a long period of time. […] It is important to have a high degree of suspicion for nonepileptic events to avoid the misdiagnosis of epilepsy. […] Diagnosis of FS can be suspected based on the history, making accurate history from witnesses among the most important initial pieces of the puzzle. […] VideoEEG monitoring is based on the principle that FS lack ictal epileptiform discharges. […] To evaluate FS, the physician ideally should be able to look at the semiology of an event or events and analyze the EEG.

• #2 Seizure – Wikipedia

  https://en.wikipedia.org/wiki/Seizure

  Laboratory testing is often performed in the evaluation of a new-onset seizure, particularly when a provoked cause is suspected. […] An electroencephalogram (EEG) records electrical activity in the brain and can help support a diagnosis of epilepsy. […] Brain imaging is recommended in most cases of new-onset unprovoked seizures to identify structural abnormalities that may predispose to epilepsy. […] Management of seizures depends on the clinical context, including whether the seizure is isolated or part of an ongoing epileptic disorder, and whether it is provoked or unprovoked. […] After a first unprovoked seizure, management depends on assessing the risk of recurrence. Antiseizure medication may be considered after a single event if risk factors for epilepsy are identified, such as epileptiform abnormalities on EEG or structural lesions on MRI. […] Long-term management applies to individuals diagnosed with epilepsy. The goals are seizure control, minimizing adverse effects, and optimizing quality of life.

• #2 Diagnosing Epilepsy & Seizure Disorders | NYU Langone Health

  https://nyulangone.org/conditions/epilepsy-seizure-disorders/diagnosis

  A doctor also uses other diagnostic tools, including the following, to determine if a person has epilepsy. […] This exam can help doctors determine whether brain function is impaired. […] If a doctor suspects epilepsy is causing your symptoms, he or she may order an electroencephalography, or EEG. This tool is the most specific test for diagnosing epilepsy because it records the electrical activity of the brain. […] Sometimes the results of a routine EEG are normal or reveal only minor, nonspecific findings. […] Video EEG monitoring allows the doctor to view your behavior and brain activity. […] A doctor may order an MRI scanin which a magnetic field and radio waves create computerized two- or three-dimensional imagesto better view the structure of the brain. […] A CT scan is a type of X-ray that creates detailed images of tissue and internal organs.

• #2 Seizures: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/neuro/seizures/treatment

  Blood tests to rule out infections, iron deficiencies, diabetes, and other underlying health issues that can trigger seizures […] Spinal tap (lumbar puncture) as needed, to remove cerebrospinal fluid and test for infections […] If you have recurring seizures even after trialing two antiseizure medications, stereotactic EEG studies (involving the insertion of small electrodes into the brain through the skull) can help localize where the seizures begin in your brain. This will help determine whether you and neuromodulation.

• #2 Epilepsy Diagnosis – Initial & Surgical Evaluation, Second Opinions

  https://www.dukehealth.org/treatments/neurological-disorders/epilepsy-diagnosis

  Neuropsychological Testing helps doctors determine which parts of your brain might not be functioning normally. […] Robot-Assisted Stereoelectroencephalography (SEEG) is used to pinpoint where a seizure starts. […] Subdural Electrodes are used when the seizure focus is difficult to pinpoint. […] Brain Mapping identifies vital areas in your brain responsible for movement, sensation, language, and vision. […] Wada Test is used to determine vital brain functions on the left versus right side of the brain. […] As a Level 4 Epilepsy Center, Duke Health provides the highest level of diagnosis, medical, and surgical treatments for people with epilepsy.

• #2 Epilepsy Diagnosis – Initial & Surgical Evaluation, Second Opinions

  https://www.dukehealth.org/treatments/neurological-disorders/epilepsy-diagnosis

  Neurogenetic Testing can help inform doctors whether your epilepsy is genetic, which can affect your treatment plan. […] If your initial evaluation results indicate that you may be a candidate for epilepsy surgery, you will need to undergo some additional testing or surgical procedures to pinpoint your seizure focus. […] Functional MRI (Magnetic Resonance Imaging) detects brain areas involved in particular functions and detects changes in blood flow in the brain. […] DTI (Diffusion Tensor Imaging) focuses on brain anatomy and enables doctors to examine complex microstructures in the brain and identify small abnormalities. […] PET (Positron Emission Tomography) investigates chemical activity and shows brain metabolism, highlighting areas of the brain where seizures begin. […] High-Density EEG and ESI (Electrical Source Imaging) provide more information about where the seizures start and how they spread.

• #2 The Diagnosis of Functional Seizures

  https://practicalneurology.com/diseases-diagnoses/epilepsy-seizures/the-diagnosis-of-functional-seizures/31887/

  VideoEEG monitoring allows simultaneous evaluation of these important aspects and is considered the gold standard for diagnosis of FS. […] The best measure of accuracy and diagnostic reliability in this situation is the videoEEG interrater agreement, which was shown to be substantial for epileptic seizures but only be moderate for diagnosis of FS. […] The general principles of videoEEG monitoring include the following. First, the presence of an ictal pattern (not normal variants or artifacts) during an event can confirm a diagnosis of epilepsy over FS. […] The absence of an ictal pattern must be interpreted in the context of the semiology on the video, because some epileptic seizures may not have an ictal pattern visible on surface EEG. […] FS are a common entity, which is usually misdiagnosed as epilepsy.

• #2 Focal seizures – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/544

  Focal seizures are the transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain originating within networks limited to one hemisphere. […] History-taking is the most important aspect of diagnosis. Supportive tests, although helpful, need not be abnormal for a diagnosis of focal seizures. […] Focal aware seizures (formerly known as simple focal seizures) are those in which consciousness is preserved. Focal impaired awareness seizures (formerly known as complex focal seizures) are characterized by loss of awareness, memory loss for the clinical event, and impaired responsiveness at the time of the event. […] The clinical definition of epilepsy includes any of the following conditions: 1) at least two unprovoked seizures occurring 24 hours apart; 2) one unprovoked seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years; 3) diagnosis of an epilepsy syndrome.

• #2 EPILEPSY CLASSIFICATION

  https://www.epilepsydiagnosis.org/epilepsy/epilepsy-classification-groupoverview.html

  Epilepsy is a disease of the brain defined by any of the following conditions: […] Diagnosis of an epilepsy syndrome. […] Epilepsy classification is undertaken after the criteria for diagnosing epilepsy are met (definition above). Classification is undertaken using a multi-level classification framework, involving classification at three levels – the seizure type, epilepsy type and epilepsy syndrome. Imaging, EEG and other investigations, where available, contribute to optimized classification at all three levels. Where possible, a diagnosis at all three levels should be established. The etiology of the epilepsy should be considered from the outset, and at each step along the diagnostic pathway. Knowing the etiology can inform optimized classification and has important treatment implications for the patient. […] Epilepsies are classified as: generalized epilepsy, focal epilepsy, combined generalized and focal epilepsy, unknown epilepsy.

• #2 Evaluation of a First Seizure | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0501/p1342.html

  Seizure is a common presentation in the emergency care setting, and new-onset epilepsy is the most common cause of unprovoked seizures. […] Electroencephalography is recommended for patients presenting with a first seizure, and neuroimaging is recommended for adults. […] Patients with a normal neurologic examination, normal test results, and no structural brain disease do not require hospitalization or antiepileptic medications. […] Electroencephalography (EEG) is recommended for all patients with new-onset seizures. […] Adults who present to the emergency department after an unprovoked first seizure should receive immediate neuroimaging of the brain if feasible. […] A lumbar puncture is indicated for patients with a history or examination results suggestive of central nervous system infection and in patients who are immunocompromised.

• #2 Evaluation and management of the first seizure in adults – UpToDate

  https://www.uptodate.com/contents/evaluation-and-management-of-the-first-seizure-in-adults

  Seizures are a common occurrence, affecting an estimated 8 to 10 percent of the population over a lifetime. Seizures account for 1 to 2 percent of all emergency department visits, and approximately one-quarter of these will be a first seizure. […] The differential diagnosis and clinical features of seizures and the diagnostic evaluation of the first seizure in adults are reviewed here. […] The initial evaluation includes making the diagnosis, which involves a detailed history, examination, blood and urine tests, electrocardiogram, neuroimaging, electroencephalography, and lumbar puncture. […] When to start antiseizure medication therapy includes with acute symptomatic seizures and with a first unprovoked seizure.

• #2 Focal seizures – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/544

  Key diagnostic factors include movement of one side of the body or one specific body part, premonitory sensation or experience, automatisms, temporary aphasia, and staring and being unaware of surroundings. […] The first tests to order include blood glucose, CBC, electrolyte panel, toxicology screen, lumbar puncture and cerebrospinal fluid analysis, CT head, MRI brain, and electroencephalogram (EEG). […] When at least two monotherapy trials fail to achieve seizure remission, dual therapy may be tried; use of drugs with different mechanisms of action should be considered to maximize efficacy and minimize toxicity. […] Patients in whom seizure remission is not achieved with two monotherapy trials followed by dual therapy are considered to have refractory focal seizures. They should be evaluated to confirm the diagnosis and for consideration of resective epilepsy surgery and/or neuromodulation therapies.

• #2 Epilepsy Diagnosis – How, where and who diagnoses Epilepsy

  https://www.cureepilepsy.org/understanding-epilepsy/diagnosing-epilepsy/how-is-epilepsy-diagnosed/

  A CT scan is often used in emergency situations to identify any potential brain injuries or bleeding that could trigger seizures. […] Although blood tests do not directly diagnose epilepsy, they help rule out other potential causes of seizures, such as infections, metabolic disorders, or genetic conditions. […] Neuropsychological tests assess cognitive and memory functions. They can provide insight into how epilepsy affects brain function, which is particularly useful for tailoring treatment plans. […] Epilepsy can be diagnosed by a variety of medical professionals in various medical settings, ranging from doctors in the emergency room to epileptologists in an epilepsy monitoring unit (EMU). […] If a person’s seizures are not controlled after three months of treatment by a PCP, or after 12 months of treatment by a neurologist, they should be referred to an Epilepsy Center.

• #2 Diagnosis – Epilepsy Action

  https://www.epilepsy.org.uk/info/diagnosis

  About 20 in 100 people (20%) diagnosed with epilepsy are wrongly diagnosed. […] Its also possible to be wrongly diagnosed with another condition. […] There is no single test that can confirm epilepsy. […] Test results may be misunderstood. […] Your symptoms and medical history are not taken accurately. […] If you think your symptoms have been misdiagnosed, it may be worth asking your specialist to go through your diagnosis with you.

• #2 Testing for Epilepsy: Getting an Epilepsy Diagnosis

  https://www.health.com/epilepsy-diagnosis-7107057

  A neurologist can conduct a manual neurological exam to assess your movement, behavior, memory, language ability, and other mental functions. […] Not all seizures are caused by epilepsy. Figuring out what caused the seizure can help inform proper treatment. […] Epilepsy is a seizure disorder that is typically diagnosed by a neurologist. The diagnosis involves taking a medical history, measuring brain activity, and conducting various tests. A healthcare provider will determine the type of epilepsy and seizures, as well as use imaging scans, like an MRI, to assess your condition. […] It is important to differentiate epilepsy with provoked seizures, which could be caused by other life-threatening conditions. An accurate diagnosis informs treatment while making patients and their caregivers aware of associated conditions like status epilepticus and SUDEP.

• #2

  https://www.who.int/news-room/fact-sheets/detail/epilepsy

  Epilepsy is defined as having two or more unprovoked seizures. […] Seizures can be controlled. Up to 70% of people living with epilepsy could become seizure free with appropriate use of antiseizure medicines. […] A documented etiology of the seizure and an abnormal electroencephalography (EEG) pattern are the two most consistent predictors of seizure recurrence. […] It is possible to diagnose and treat most people with epilepsy at the primary health-care level without the use of sophisticated equipment. […] WHO pilot projects have indicated that training primary health-care providers to diagnose and treat epilepsy can effectively reduce the epilepsy treatment gap.

• #2 Childhood Epilepsy: Diagnosis

  https://www.massgeneral.org/children/epilepsy/education/diagnosis

  However, one seizure does not lead to a diagnosis of epilepsy, nor does it necessarily indicate any immediate course of treatment. […] In practice, doctors often do not treat a single seizure because approximately 60 to 70 percent of individuals who have one seizure will never have a second. […] For children who experience recurrent seizures, the diagnostic and treatment protocol is aimed at providing complete seizure control. […] Importantly, certain types of anticonvulsant medications and other treatments are most effective on particular seizure types. […] Accurate diagnosis is a critical step both in epilepsy treatment and in the prevention of developmental delays. […] Eyewitness accounts of seizure events provide information that is critical to developing an accurate diagnosis.

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