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Our brain cells are organized in networks, each of which controls a certain function. For example, one network ensures you can talk, while the other allows you to bend your knees or remember things. The networks are interconnected. A short-circuit may become visible in various ways, depending on the networks that are involved. Someone may fall, shock, make uncontrolled movements, smell something unusual, be absent of become unconscious. As there are many different manifestations, (the type of) epilepsy is not always recognized.
There are many manifestations of epilepsy. Seizures may vary in character, intensity, length and frequency. Even though seizures can vary, they can be divided in two main groups: generalized seizures and focal seizures. In the case of generalized seizures, the short-circuit is divided over both cerebral hemispheres from the onset and consciousness is always disturbed. In the case of a focal seizure, part of the brain is involved. And with other seizures it is unclear in what part of the brain they originate.
When a type of epilepsy is characterized by a certain type of seizures and certain deviations in the EEG, we can speak of an epilepsy syndrome. An epilepsy syndrome can be dealt with through a certain treatment. This sounds easier than it is. Some syndromes, such as absence-epilepsy, usually have a good prognosis and can be successfully treated. However, there are many types of – often rare – syndromes that have a less than favorable prognosis. In these cases, the seizures are harder to treat, causing the cognitive development to deteriorate. Often, there are additional problems.
For a good treatment it is important to know what type of seizure or what type of epilepsy it concerns. In order to establish a good diagnosis, the neurologist needs to know exactly how and when the seizures start, hoe the seizure progresses, how long it lasts etc. Sometimes the patient can supply this information. It is often valuable when a family member or other close relative or friend can help to describe the seizure.
When epilepsy is suspected, an EEG is made. The neurologist infers information concerning the seizures from the patterns on this EEG.