The definition of epilepsy and its classification

1. Big picture

Epilepsy is not the same as “having one seizure.” This is the most important exam point. A seizure is an event; epilepsy is a chronic tendency of the brain to produce recurrent, usually unprovoked epileptic seizures.

In the oral exam, the examiner usually wants you to explain three things clearly:

1. What is epilepsy?

2. What is the difference between provoked seizure and epilepsy?

3. How are epileptic seizures classified?

The practical clinical definition used in modern neurology is that epilepsy can be diagnosed after at least two unprovoked or reflex seizures more than 24 hours apart, or after one unprovoked seizure if the predicted recurrence risk is high, or if an epilepsy syndrome is diagnosed. The classic lecture/exam wording is simpler: epilepsy means recurrent, non-provoked epileptic seizures.