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

Although movement disorders (MDs) and seizures are considered separate neurological conditions, it can be difficult to distinguish between them in clinical settings. This is primarily due to the numerous motor manifestations that overlap between seizures and movement disorders. Furthermore, the coexistence of both movement disorders and seizures within the same individual adds another layer of complexity to the diagnostic process.

The purpose of this review is to compile a comprehensive guide for distinguishing between seizures and movement disorders.

We draw attention to the common phenomenology of seizures and movement disorders, the areas of diagnostic ambiguity, and the crucial clinical elements that can direct a precise diagnosis. A structured narrative review was conducted based on a systematic PubMed/MEDLINE search (years 1980-2025), synthesising clinical, neurophysiological, and genetic literature relevant to the diagnostic overlap between seizures and movement disorders.

Ten diagnostic pillars are offered as useful instruments to explore the intricate connection between seizures and movement disorders.

Clinical reasoning must integrate multiple overlapping dimensions when distinguishing seizures from movement disorders. No single test or isolated feature is definitive; a holistic, interdisciplinary approach is critical in navigating this diagnostic interface. It is, however, important to emphasize that the strict distinction between movement disorders and seizures may not always be necessary or possible, given that both conditions are ultimately defined by different constructs: phenomenology and pathophysiology, respectively.