[Advances in the diagnosis of epilepsy]

INTRODUCTION. Over the past ten years, evaluation of epilepsy has changed drastically thanks to the development of diagnostic procedures which have transformed understanding of the neurophysiological basis of the development of convulsive seizures. In the USA alone 2 million people are affected by this disease. Of these approximately 20% continued to have seizures in spite of receiving medical treatment. This means that the condition is of a priority for public health attention in any country. Technology used in many areas of diagnosis has allowed the patient with epilepsy to be managed in a much more integrated manner, and therefore to have better possibilities regarding quality of life . DEVELOPMENT. We define these technological advances in three areas in which progress has fortunately been outstanding. Firstly, obtention of better anatomical and functional images permit correlation of the pathology with a specific type of epileptogenic activity. Secondly, understanding the electro clinical semiology resulting from the generation of abnormal cortical activity with subsequent activation of different areas of the cerebral cortex, has made it possible to treat epilepsy surgically. Finally the discovery of genes affecting the presentation of a particular epilepsy syndrome defines the diagnosis and give orientation as to treatment and prognosis in particular cases.