Pitfalls in the diagnosis and differential diagnosis of epilepsy

Epilepsy affects 1 in 200 children. Appropriate management relies on accurate diagnosis. However, there is no single diagnostic test; diagnosis is based on the history of attacks with support from investigation. The rate of misdiagnosis remains high amongst children; most commonly due to the rush to make a diagnosis and lack of awareness of alternatives on the part of the assessor. Assessment of children presenting with paroxysmal events should be undertaken by a paediatrician with expertise and training in epilepsy, working within a network linked to tertiary paediatric neurology.