Diagnostic Problems in the Initial Assessment of Epilepsy

Background: On most occasions, the diagnosis of seizures and epilepsy is considered in cases of temporary disturbance of neurologic function. In this clinical situation, the physician in charge (neurologist, emergency physician, general practitioner, intensivist, cardiologist, psychiatrist, etc.) should establish the differential diagnosis with other pathologies that can also cause transient neurologic disturbances. Review Summary: We will review the relevant literature about the diagnostic process and the differential diagnosis of epileptic seizures and epilepsy at the onset of the disease, and the medical consequences of an incorrect diagnosis. Conclusion: Neurologists and non-neurologists often diagnose epilepsy. The diagnostic challenge consists of correctly interpreting the medical history, characteristics of the episodes and physical and neurologic examination, and properly using and interpreting supplemental paraclinical tests.