From the Guidelines
There is a significant difference between seizures and epilepsy, with seizures being transient occurrences of abnormal neuronal activity and epilepsy being a chronic condition characterized by recurrent, unprovoked seizures. Seizures are single events that can be caused by various factors such as high fever, head injury, or drug withdrawal, and can occur in anyone 1. On the other hand, epilepsy is a neurological disorder defined by the International League Against Epilepsy (ILAE) as having at least two unprovoked seizures occurring more than 24 hours apart, or one unprovoked seizure with a high probability of further seizures 1.
Some key points to consider are:
- Seizures can be classified into focal onset, generalized onset, or unknown onset, with focal seizures arising within networks of a single cerebral hemisphere and generalized seizures rapidly affecting both hemispheres 1.
- Epilepsy affects approximately 1.2% of the United States population, corresponding to around 3.4 million people, and about 10% of the population experiences at least one epileptic seizure during their lifetime 1.
- The classification of seizures is important for etiologic diagnosis, appropriate treatment, and accurate prognostication, and the ILAE classification system is useful for communication, teaching, research, and patient care 1.
In terms of treatment, the approach differs based on whether a person has had a single seizure or has been diagnosed with epilepsy, with long-term antiepileptic medications often prescribed for epilepsy 1. Understanding the distinction between seizures and epilepsy is crucial for proper diagnosis, treatment, and management of these neurological events.
From the Research
Definition and Distinction
- Seizures are defined as uncontrolled hypersynchronous electrical discharges of neurons in the brain that interfere with normal function, and are a symptom of an underlying disorder 2.
- Epilepsy, on the other hand, is a condition of recurring seizures that do not have a reversible metabolic cause 2.
- The distinction between epilepsy and seizures is crucial, as seizures can be confused with a variety of other conditions, making an accurate diagnosis challenging 2, 3, 4.
Clinical Features and Diagnosis
- The diagnosis of seizures and epilepsy often depends on a careful history, and is supported with electroencephalogram and imaging 5.
- A thorough evaluation is necessary to diagnose and manage epilepsy effectively, including identifying the underlying cause of seizures and ruling out other conditions 3, 4.
- Paroxysmal events, such as syncope and psychogenic non-epileptic seizures, can be mistaken for epileptic seizures, highlighting the importance of accurate diagnosis 4.
Management and Treatment
- Drug therapy is the mainstay of epilepsy treatment, but surgery and vagal nerve stimulation are options for selected refractory cases 2.
- Antiepileptic drugs must be chosen with the patient's particular comorbidities in mind, and drug-resistant epilepsy cases should be referred to an epilepsy specialist 5.
- The management of epilepsy also involves considering the psychosocial consequences of recurring seizures, which can be significant for patients 2.