Definitions and Epidemiology

Abstract

An epileptic seizure may be defined as a discrete spontaneous alteration in behavior or a subjective experience occurring due to an abnormal hypersynchronous excessive discharge of a collection of neurons within the brain. Seizures are commonly encountered in hospital practice. Such seizures are often provoked situation-related seizures and occur in patients who do not have epilepsy (defined as recurrent unprovoked seizures) (Fig. 1) (1,2). These provoked seizures are also referred to as acute symptomatic seizures and may occur in patients being cared for by general practitioners, internists, surgeons, emergency department physicians, intensivists, anesthesiologists, and other specialists. The evaluation and management of these patients is a significant proportion of the consultative workload of neurologists in hospital practice. Yet, these symptomatic seizures have been relatively ignored in the neurology literature in relation to their importance and frequency in clinical practice. The proper evaluation of acute symptomatic seizures is critical in guiding management, optimizing neurologic outcome, and often avoiding unnecessary long-term treatment with inappropriate and sometimes toxic therapy with anticonvulsant medications.