For example, a lot of funny baby movements and “staring spells” are simply normal behaviours. There is an enormous range of what seizures can look like, which I briefly reviewed on my blog for neurology education 6, so it makes sense that a lot of patients, bystanders, and even physicians have trouble deciphering what is a seizure and what is not. What you might not have known is all that shakes is not seizure. All elements of the patient’s history, physical exam, brain imaging, and electroencephalography 5 (EEG) should be taken into careful consideration before an epilepsy diagnosis is made and the patient is started a medication. Therefore, having a single seizure doesn’t necessarily justify treatment to prevent future seizures 4. The fact of the matter is, as many as 1 in 10 people worldwide will experience a seizure in their lifetime, but only 3% will have recurrent seizures.
The reason doctors make a diagnosis of epilepsy is to justify to themselves (and to the patients) whether it is the right move to treat a patient who has experienced a seizure. Is the juice worth the squeeze? Let’s think about it. The reason for such stringent criteria is based on a simple concept. One unprovoked seizure and a high probability (60% chance) of a second unprovoked seizure in the next 10 years According to the International League Against Epilepsy 2 (ILAE), the world’s foremost authority on the matter, a patient is diagnosed with epilepsy if they meet any of the following 3 criteria: It turns out, there are very specific criteria that have been provided by internationally recognized and peer-reviewed collaborations 1. If you have seizures, basically you have epilepsy, right? Epilepsy seems like a pretty straightforward diagnosis to make.
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