How are symptomatic (nonepileptic) seizures defined?

Updated: Nov 30, 2017
  • Author: Eissa Ibrahim AlEissa, MD, MBBS; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Symptomatic seizure is a seizure caused by a previously known or suspected disorder of the CNS. This type of seizure is associated with a previous CNS insult known to increase the risk of developing epilepsy.

An acute symptomatic seizure is one that occurs following a recent acute disorder such as a metabolic insult, toxic insult, CNS infection, stroke, brain trauma, cerebral hemorrhage, medication toxicity, alcohol withdrawal, or drug withdrawal. An example of an acute symptomatic seizure is a seizure that occurs within 1 week of a stroke or head injury. Studies have reported that 25-30% of first seizures are acute symptomatic seizures. [8]

A remote symptomatic seizure is a seizure that occurs longer than 1 week following a disorder that is known to increase the risk of developing epilepsy. The seizure may occur a long time after the disorder. These disorders may produce static or progressive brain lesions. An example of a remote symptomatic seizure is a seizure that first occurs 6 months following a traumatic brain injury or stroke.

Seizures are also classified as provoked or unprovoked. A provoked seizure is an acute symptomatic seizure. An unprovoked seizure is a cryptogenic or a remote symptomatic seizure.

Compared with an epileptic seizure, a nonepileptic event is a clinical event that can mimic, and be mistaken for, an epileptic seizure. Examples of nonepileptic events that mimic seizures include syncope and psychogenic nonepileptic attacks (PNEAs). Syncope is caused by decreased cerebral perfusion that results mostly from a decrease in the cardiac output, which results in loss of consciousness.


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