From the Guidelines
A seizure is a single episode of abnormal electrical activity in the brain, whereas epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures, with the key difference being that epilepsy represents an ongoing condition where a person has a tendency to experience repeated seizures over time. The distinction between seizure and epilepsy is crucial, as it affects treatment approaches and patient management. According to the International League Against Epilepsy (ILAE), epilepsy is defined as having at least two unprovoked seizures occurring more than 24 hours apart, or one unprovoked seizure with a probability of further seizures similar to the general recurrence risk after two unprovoked seizures, occurring over the next 10 years, or a diagnosis of an epilepsy syndrome 1.
Some key points to consider when differentiating between seizure and epilepsy include:
- Seizures can be classified as 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 can be caused by underlying factors such as genetic predisposition, brain injury, stroke, infection, or developmental disorders, and affects approximately 1.2% of the United States population, corresponding to around 3.4 million people 1.
- The treatment approaches for seizure and epilepsy differ significantly, with a single seizure potentially not requiring long-term medication, whereas epilepsy typically requires ongoing management with antiepileptic drugs to prevent future seizures.
It is essential to understand this distinction, as a single seizure does not necessarily mean someone has epilepsy, and the diagnosis of epilepsy requires a comprehensive evaluation, including a thorough medical history, physical examination, and diagnostic tests such as electroencephalography (EEG) and imaging studies 1. By recognizing the difference between seizure and epilepsy, healthcare providers can develop effective treatment plans and improve patient outcomes.
From the Research
Definition of Seizure and Epilepsy
- A seizure is a symptom that occurs in acute illness, either provoked or unprovoked, and can be a one-time event or a recurring condition 2.
- Epilepsy, on the other hand, is a chronic neurologic disorder characterized by the spontaneous recurrence of unprovoked seizures, affecting 1% to 3% of the population 2, 3.
Key Differences
- The main difference between a seizure and epilepsy is that a seizure is a single event, whereas epilepsy is a chronic condition with recurring seizures 2, 4.
- Seizures can be provoked by various factors, such as acute illness or injury, whereas epilepsy is characterized by unprovoked seizures 2, 3.
- Epilepsy is a disorder that affects the brain, with an enduring predisposition to generate seizures, and is often associated with neurobiologic, cognitive, psychological, and social consequences 4, 5.
Diagnosis and Classification
- Classification of seizure type and epilepsy syndrome is important for diagnosis, treatment, and prognosis 2, 5.
- The International League Against Epilepsy (ILAE) has proposed a practical clinical definition of epilepsy, which includes having at least two unprovoked seizures, one unprovoked seizure with a high probability of further seizures, or a diagnosis of an epilepsy syndrome 5.
- Diagnosis of epilepsy often involves a combination of clinical evaluation, electroencephalography (EEG), and neuroimaging studies 2, 3.
Treatment and Management
- Treatment for seizures and epilepsy depends on the underlying cause, severity, and frequency of seizures, and may include antiepileptic drugs, surgery, or other therapies 2, 6.
- Vagus nerve stimulation (VNS) is a neuromodulatory treatment that can be effective for treating medically refractory epilepsy 6.
- Epilepsy surgery can be an effective treatment option for patients with temporal lobe epilepsy, with 60% to 70% of patients becoming free of disabling seizures 2.