In terms of the differential diagnosis of epilepsy, clinical seizure events can be divided into seizures and non-epileptic seizures. The first step in the correct diagnosis of epilepsy is to determine whether a clinical seizure event is a seizure or another non-epileptic seizure. By definition, a seizure is essentially a sudden abnormal discharge of brain neurons resulting in a clinical manifestation that is transient, recurrent and stereotyped and accompanied by epileptiform discharges on the electroencephalogram. Non-epileptic seizures are all other seizure events with clinical manifestations similar to those of epileptic seizures. Non-epileptic seizures include psychogenic seizures, syncope, various episodic sensory/motor/autonomic symptoms, sleep disorders, and seizure symptoms due to infection and metabolic toxicity. It is also difficult to make an accurate diagnosis when encountering atypical seizure presentation, incomplete history, or overlapping seizure and non-seizure symptoms. Misdiagnosis of epilepsy has more serious consequences. If a patient who is not epileptic is misdiagnosed with epilepsy, he or she may be wrongly given antiepileptic drugs and miss out on specific treatment for the primary cause or even the correct life-saving treatment. Therefore, when the diagnosis is not clinically clear, it needs to be repeated and the condition deliberated to try to improve the accuracy of the clinical diagnosis. Differentiation of common non-epileptic seizures from epileptic seizures: 1. Syncope Syncope manifests as a sudden brief reversible loss of consciousness with postural hypotonia or loss of posture, caused by a sudden decrease in whole-brain blood perfusion, and normalizes with the restoration of cerebral blood flow. In syncope, the patient’s seizure is mostly seen in the standing or sitting position, often triggered by mental tension, painful stimulation, etc. In the early stages of syncope, the most fixed eye movement manifestation is eye up-turning, followed by eye deviation to one side. Visual hallucinations (graying of the visual field, colored patches, flashes of light) are rare, while auditory hallucinations (sounds of instruments, buzzing sounds, raw sounds of people talking with lack of content) are relatively common in syncope (60%). 2. Psychogenic non-epileptic seizures Psychogenic non-epileptic seizures are the most common recurrent seizure-like events in clinical practice and can be caused by a variety of psychological disorders. Patients with psychogenic nonepileptic seizures, often accompanied by severe depression, anxiety, mental stress, anger, fear, and panic, if seizure events are often triggered by environmental stress, respond to cues; occur easily while awake and in the presence of witnesses; lack a fixed form of seizure; have a preserved or markedly fluctuating state of consciousness during the seizure; lack a post-seizure period of clouded consciousness, patients may Seizures may be followed by emotional manifestations and crying; convulsive symptoms with torso writhing and tremors with eye avoidance; ineffective antiepileptic drug therapy. 3, transient ischemic attack Transient ischemic attack clinically manifests as symptoms of neurological deficits, such as hemiparesis, hemianopia, and hemianesthesia, while seizures are mostly irritating symptoms, such as convulsions, etc. TIA is mostly seen in middle-aged and elderly people with risk factors for cerebrovascular disease. 4. Sleep disorders include episodic sleep disorder, sleep apnea, night terrors, sleep walking disorder, nightmares, etc. Most of them occur during sleep or sleep-wake transition. The seizures are mostly unconscious and contain motor and behavioral components. Since many seizure types also tend to develop during sleep and also manifest as certain motor and physician disorders, such as tonic-clonic seizures during sleep and certain seizures of frontal lobe origin, sleep disorders are easily misdiagnosed as seizures. Long-range video EEG monitoring is mostly required to identify them.