Chapter 1 - Paroxysmal attacks: diagnostic gold standards and history-taking

Summary

The gold standard case history is of particularly high importance in paroxysmal disorders because many seizures may comprise a variety of subjective symptoms or may even consist exclusively of these symptoms. Taking a seizure history is primarily for diagnostic purposes, largely to differentiate epilepsy from other seizure-like disorders but also to distinguish between different types of epileptic seizures and to understand the anatomy and etiology of these events. Hypotheses are formed, followed-up or refuted, and they determine the subsequent course of the interview. Such an in-depth dialogue also opens up perspectives beyond diagnostics. Beyond providing diagnostic clues and anatomical understanding, another frequent consequence of these interviews is indications for the best further therapeutic strategy. Verbal communication is only successful when the partners in dialogue find a common language. A dialogue is frequently necessary to get the full picture of all subjective seizure symptoms and their sequence.