Epilepsy update: diagnosis, classification and management

Careful clinical evaluation differentiates epileptic seizures from syncope (vasovagal or cardiogenic), dissociative seizures (non-epileptic attack disorder) and other rarer paroxysmal events. The initial diagnosis of epilepsy is incorrect in 20%–30% of patients. Investigations can include blood test...

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Published inMedicine (Abingdon. 1995, UK ed.) Vol. 51; no. 8; pp. 545 - 551
Main Authors Harris, Lauren, Angus-Leppan, Heather
Format Journal Article
LanguageEnglish
Published Elsevier Ltd 01.08.2023
Subjects
Anti-seizure medication
epilepsy
focal
generalized
Internal Medicine
seizure
status epilepticus
epilepsy
status epilepticus
generalized
seizure
focal
Anti-seizure medication
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Summary:Careful clinical evaluation differentiates epileptic seizures from syncope (vasovagal or cardiogenic), dissociative seizures (non-epileptic attack disorder) and other rarer paroxysmal events. The initial diagnosis of epilepsy is incorrect in 20%–30% of patients. Investigations can include blood tests, electrocardiograms, electroencephalograms and neuro-imaging. Patients should be informed and counselled about the diagnosis. Anti-seizure medications (ASMs) are the first-line treatment for epilepsy, the choice depending on the epilepsy syndrome, seizure type, patient and their co-morbidities. Surgical options are available for refractory epilepsy. Status epilepticus is a medical emergency and all clinicians should be aware of the treatment algorithm. This update additionally explores autoimmune-related epilepsy, developments in ASMs, including cannabinoids, and automated systems for seizure detection.
ISSN:1357-3039
DOI:10.1016/j.mpmed.2023.05.011