Approximately 2 million persons in the United States have epilepsy,1,2making the prevalence of this disorder similar to that of type1 diabetes mellitus.3 Each year, 100,000 new cases of epilepsyare diagnosed in the United States.1,4 Both the prevalence andthe incidence of epilepsy are dramatically higher among elderlypersons than among those who are younger.1 Thus, many primarycare physicians care for a substantial number of patients withepilepsy.
Evaluation
Diagnosis of a Seizure Disorder
The first step in the evaluation of a patient with possibleepilepsy is to determine whether the patient does or does nothave seizures. An incorrect diagnosis of a . . . [Full Text of this Article]
Diagnosis of the Underlying Cause
History
Physical Examination
Electroencephalographic Studies
Laboratory Tests and Neuroimaging
Diagnostic Formulation and Treatment Plan
Selection and Adjustment of Medications
Initial Toxicity
Toxic Effects during Long-Term Therapy
Inadequate Seizure Control
Discontinuing Therapy
When to Seek Neurologic Consultation
Refractory Status Epilepticus
Other Conditions
Routine Consultations
Source Information
From the Department of Neurology, Boston University School of Medicine, and the Neurology Service, Department of Veterans Affairs Boston Healthcare System (T.R.B.); and the Department of Neurology, Harvard Medical School and Children's Hospital (G.L.H.) — all in Boston.
Address reprint requests to Dr. Browne at the Department of Neurology, Boston University School of Medicine, 315 Albany St., C-314, Boston, MA 02118, or at tbrowne@bu.edu.
References
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A correction has been published: N Engl J Med 2001;344(25):1956.
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