Epilepsy
A disorder of enduring susceptibility to recurrent seizures caused by abnormal, hypersynchronous electrical activity in brain networks; diagnosis is clinical, seizure type determines treatment, and prolonged or repeated seizures are emergencies.
Definition
Epilepsy is a disorder of enduring predisposition to generate epileptic seizures, usually diagnosed after 2 unprovoked seizures more than 24 hours apart, or after one unprovoked seizure when the predicted recurrence risk is sufficiently high. A seizure provoked by an acute reversible insult is not automatically epilepsy.
First principles
A seizure is a transient clinical event, not a diagnosis by itself
A seizure is a brief episode of abnormal electrical activity in the brain. It may be provoked by a reversible insult such as hypoglycaemia, intoxication or withdrawal, infection, acute stroke or head injury, or it may reflect an enduring predisposition to recur. Epilepsy is diagnosed clinically when the pattern and recurrence risk indicate an enduring tendency, not simply because a convulsion occurred or an EEG is abnormal.
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