Epilepsy is defined as the recurrent paroxysmal transient disturbance of brain function due to disturbance of electrical activity in the brain, where the disturbance is unrelated to infection or acute cerebral insult. The disturbances may be manifested as episodic impairment or loss of consciousness, abnormal motor phenomena, psychic or sensory disturbances, or perturbation of the autonomic nervous system.

It is a diagnosis which sadly and unneccessarily carries a social stigma. As such, it ought not to be applied without thorough consideration.

Note that there is confusion between the terms epilepsy and seizure, and they are often used interchangeably. The confusion is not helped by the term status epilepticus, which need not have anything to do with epilepsy. The two are separated here.

Regarding diagnosis and management of epilepsy, NICE state that (1):

• the diagnosis of epilepsy in adults should be established by a specialist medical practitioner with training and expertise in epilepsy
  • it is recommended that people having a first seizure should be seen as soon as possible by a specialist in the management of the epilepsies to ensure precise and early diagnosis and initiation of therapy as appropriate to their needs
• the diagnosis of epilepsy in children should be established by a specialist paediatrician with training and expertise in epilepsy
  • it is recommended that all children who have had a first non-febrile seizure should be seen as soon as possible by a specialist in the management of the epilepsies to ensure precise and early diagnosis and initiation of therapy as appropriate to their needs

Reference:

1. NICE (October 2004).The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care.