Diagnosis of epilepsy

Differential diagnosis. On what position to stand in relation to the pathogenesis of epilepsy (self-epileptic disease, epilepsy as a syndrome), it is necessary first of all to recognize epileptic seizure. A number of paroxysmal conditions may remind epileptic seizure. Seizures in hysteria there are now quite rare.
In childhood meet convulsions, different in origin, due to the increased tendency of young children to convulsive response. Children with epilepsy should be distinguished from other types of seizures (psychogenic, generalized tick, neurovegetative fainting, narcolepsy, spazmofiliya and so on)that is not always easy or even possible in the short observation. Cramps more rough organic nature are common in children with meningitis, encephalitis, birth trauma, tumors, and so On of a similar nature with known seizure likely indicate its long duration, unilateralism, local cramps, the prevalence of the tonic component, temporary paralysis, paresis, aphasia, and so on, But quite often in children there are also the more benign apnoea seizures: in spazmofilii initial symptomatic seizures (in the beginning of pneumonia, scarlet fever and so on), toxic convulsions, and so on Worm infestation is not given.

Forms of oscillations arising from epileptic seizures: 1 - at large (quick wave of high voltage); 2-with a small (fast peaks and slow waves); 3 - in the case of small seizure (slow wave and edge); 4 - when psychomotor seizures (high voltage, 6 in 1 sec.).

Baby epileptic seizures can occur atypical, in the form of isolated aura; often the process is characterized by the abundance of small seizures, to which only later joined by spasmodic large and small seizures can occur rarely. A kind of forerunner of epilepsy can sometimes be night Segodnia (somnambulism). This elementary epileptic automaticity, during which cannot awaken the patient, unlike siohodni neurotic and reactive nature.
In megprobalja period of epilepsy in the EEG can be identified various changes bioelectric activity: spades, acute and slow waves, frequent high-voltage acute and slow waves, the "slow - wave edge 2-4 in 1 sec. (often 3 fluctuations in 1 sec.) and others, called subclinical seizure discharge (Fig.). The frequency of these changes, according to various authors, varies within wide limits. Vocalnet epileptic focus is set in 50% of cases [Penfield, Jasper (N. Jasper), A. Aliev], with traumatic epilepsy - in 99% [F. Gibbs, E. Gibbs, Merritt (N. Merritt)].