Diagnosis

Diagnosing epilepsy is not easy, and misdiagnosis occurs in around 25% of cases. An adequate diagnosis of epilepsy requires

• differentiation between seizures and other causes of transient neurological disturbance and collapse
• differentiation between acute symptomatic and unprovoked epileptic seizures
• classification of the disorder and identification of the cause so as to optimise treatment (1)

Regarding diagnosis of epilepsy, NICE state that (2):

• a specialist medical practitioner with training and expertise in epilepsy should establish the diagnosis of epilepsy in an adult while a specialist paediatrician with training and expertise in epilepsy should confirm the diagnosis of epilepsy in children and the young.
• it is recommended that all adults having a first seizure should be seen as soon as possible by a specialist in the management of epilepsies to ensure precise and early diagnosis and initiation of therapy as appropriate to their needs
• it is recommended that all children and young people who have had a first non-febrile seizure should be seen as soon as possible by a specialist in the management of the epilepsies to ensure precise and early diagnosis and initiation of therapy as appropriate to their needs.

Reference:

• (1) National Clinical Guideline Centre (NCGC) 2012. The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care.