title: Diagnosis of Epilepsy and Related Episodic Disorders.
abstract: OBJECTIVE
  This review identifies the diverse and variable clinical presentations associated with epilepsy that may create challenges in diagnosis and treatment.
  
  
  RESULTS
  Epilepsy has recently been redefined as a disease characterized by one or more seizures with a relatively high recurrence risk (ie, 60% or greater likelihood). The implication of this definition for therapy is that antiepileptic drug therapy may be initiated following a first seizure in certain situations.EEG remains the most commonly used study in the evaluation of people with epilepsy. Routine EEG may assist in diagnosis, classification of seizure type(s), identification of treatment, and monitoring the efficacy of therapy. Video-EEG monitoring permits seizure classification, assessment of psychogenic nonepileptic seizures, and evaluation of candidacy for epilepsy surgery. MRI is pivotal in elucidating the etiology of the seizure disorder and in suggesting the localization of seizure onset.
  
  
  CONCLUSIONS
  This article reviews the new International League Against Epilepsy practical clinical definition for epilepsy and the differential diagnosis of other physiologic paroxysmal spells, including syncope, parasomnias, transient ischemic attacks, and migraine, as well as psychogenic nonepileptic seizures. The initial investigational approaches to new-onset epilepsy are considered, including neuroimaging and neurophysiologic investigations with interictal and ictal video-EEG. Neurologists should maintain a high index of suspicion for epilepsy when children or adults present with a single paroxysmal spell or recurrent episodic events.
authors: Erik K
authors: EK
authors: St Louis
authors: Gregory D
authors: GD
authors: Cascino
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D012640:Seizures / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D055815:Young Adult
chemical_list: D000927:Anticonvulsants