Rinsho Shinkeigaku (Clinical Neurology)

Educational Lecture 2

Diagnostic approach for studying epileptic seizure

Keiko Usui, M.D., Ph.D., Kiyohito Terada, M.D., Ph.D. and Yushi Inoue, M.D., Ph.D.

National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders

Epilepsy is a chronic neurological disorder characterized by recurrent seizures that are caused by abnormal and excessive cerebral neuronal discharges. The clinical symptoms are paroxysmal, and may include impaired consciousness and/or motor, sensory, autonomic, or psychic events. Diagnosis of epilepsy is not always straightforward and clear-cut. A seizure is only a symptom that indicates neuronal dysfunction. Other diseases can cause paroxysmal events, which look very much like a seizure but in fact are nonepileptic. Such nonepileptic events include syncope, acute symptomatic seizures, and psychogenic nonepileptic seizures. To identify epileptic seizures and to classify the type of epilepsy, clinical, electroencephalographic (EEG), and/or neuroimaging findings are the fundamentals. Knowledge of the different types of seizures is essential to guide the physician in obtaining the history which leads to the diagnosis of seizure and epilepsy. In real situations, however, it is rare for physicians to actually witness the event of seizure. This lecture provides valuable opportunity to experience "real life" clinical diagnosis of epileptic seizures by showing the video of patient under seizure and EEG data. Representative visual examples of symptoms together with the detailed medical knowledge will greatly enhance the capability of diagnosis, the effectiveness of treatment, and help develop clinical strategies.
Full Text of this Article in Japanese PDF (334K)

(CLINICA NEUROL, 52: 857|860, 2012)
key words: epileptic seizure type, classification, generalized seizure, focal seizure, localizing sign

(Received: 24-May-12)