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Link: Clinical Aspects of the Diagnosis of Epileptic Seizures and Epileptic Syndromes

Patients with epileptic seizures and their families are entitled to a diagnosis, prognosis and management that are specific and precise. The inclusive, monolectic diagnostic label ‘epilepsy’ is unsatisfactory to patient and physician alike and may result in avoidable morbidity and mortality. ‘Epilepsy’ is not a single disease entity. Epilepsies are many syndromes and diseases that have a multitude of different manifestations and causes. Effective classification of epileptic seizures and syndromes is indispensable for appropriate management and prognosis. The short-and long-term management of epilepsies is often syndrome related and differs markedly between various disorders manifesting with seizures, thereby emphasising the need for accurate diagnosis.

This Chapter 1 goes on to discuss the differential diagnosis of “paroxymal events”.

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. The differential diagnosis includes all causes of episodic impairment of awareness, aberrations of mental function, falls, sensory/motor phenomena and generalised convulsive movements, which are common presenting symptoms of epileptic seizures. This is often easy for physicians adequately trained in the recognition of the various forms of epileptic seizures, who are able to obtain a clear history of the events from the patient and witnesses. However, even the most experienced epileptologists time and again have great difficulties in reaching an unequivocal diagnosis for reasons such as atypical seizure presentations, inadequate historical data or overlapping symptom manifestations.

The full text of this chapter can be found at http://www.ncbi.nlm.nih.gov/books/NBK2609/.

Copyright © 2005, Bladon Medical Publishing, an imprint of Springer Science+Business Media.

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