Navigating diagnostic overlap between seizures and movement disorders: A practical clinical approach

Area of Science:

• Neurology
• Clinical Neuroscience

Background:

• Movement disorders (MDs) and seizures share overlapping motor manifestations, complicating clinical differentiation.
• The co-occurrence of both conditions in a single patient further increases diagnostic complexity.

Purpose of the Study:

• To provide a comprehensive guide for distinguishing between seizures and movement disorders.
• To synthesize current literature on the diagnostic overlap between these neurological conditions.

Main Methods:

• A structured narrative review of clinical, neurophysiological, and genetic literature was performed.
• A systematic PubMed/MEDLINE search (1980-2025) informed the review.
• Focus was placed on common phenomenology, diagnostic ambiguities, and key diagnostic elements.

Main Results:

• Ten diagnostic pillars are presented to aid in understanding the relationship between seizures and movement disorders.
• The review highlights crucial clinical elements for precise diagnosis.

Conclusions:

• Accurate diagnosis requires integrating multiple dimensions and a holistic, interdisciplinary approach.
• A strict distinction between seizures and movement disorders may not always be feasible or necessary, as they are defined by different constructs (phenomenology vs. pathophysiology).