Seizures and epilepsy. Understanding the mechanisms, achieving control

Because seizures are a sign of dysfunction of the CNS, thorough evaluation of patients is necessary prior to treatment. Patient and family histories are essential in diagnosis, and electroencephalography, computed tomography, and information obtained from observers are useful as well. Before deciding whether or not to treat a patient, the physician needs to determine the probability of recurrence of seizures, based on the results of diagnostic evaluation. In the majority of patients, seizures can be controlled by proper drug therapy; even better drugs should be available within the next few years. If a seizure is determined to be nonepileptic, specific intervention techniques such as psychiatric counseling may be needed.