Epilepsy definition and diagnostic principles

  Epilepsy, commonly known as “sheep epilepsy,” is a group of syndromes caused by highly synchronized abnormal discharges of neurons in the brain of known or unknown etiology. Epilepsy is characterized by recurrent, transient, episodic, and often stereotypic malfunctions of the central nervous system. Due to the location of abnormal neuronal discharges and the extent of discharge and spread, seizures may manifest as sensory, consciousness, behavioral, motor, psychiatric, and autonomic dysfunction or a combination of these. Each seizure may be referred to as an epileptic seizure, and recurrent seizures resulting from a persistent susceptibility to epilepsy are called epilepsy. The epilepsy syndrome is a specific epileptic phenomenon consisting of specific signs and symptoms.  The diagnosis of epilepsy is based on a three-step approach: 1) qualitative diagnosis, i.e., to clarify whether the epilepsy is epileptic; 2) diagnosis of the type of seizure: to differentiate between seizure types or epileptic syndromes on the basis of whether it is epileptic; 3) diagnosis of the cause: to clarify the cause of the epilepsy and to make a correct estimate of the degree of disability of the epileptic patient, if possible.  The two necessary elements of epilepsy are clinical seizures and epileptiform discharges on the EEG. Epileptiform discharges on the EEG alone are not diagnostic of epilepsy because about 1% of the normal population may also have epileptiform discharges on the EEG, and epileptiform discharges may also be present in other non-epileptic disorders. The diagnosis of epilepsy cannot be made with clinical seizures alone.