Differential diagnosis

The differential diagnosis of seizures in people with developmental disability differs little from those without. This includes psychogenic non-epileptic episodes (ie psychogenic non-epileptic seizures, pseudoseizures), which can coexist with epilepsy.

Carers may be concerned that episodes of aggression represent seizures; however, this is rare. Indicators that differentiate aggression from a seizure include provocation by stress, directed aggression, duration greater than 3 minutes, ability to recall the event, and remorse. Specialist advice is recommended if there is uncertainty, and to exclude seizures as a cause of behaviours of concern.

Video-EEG (combined electroencephalogram [EEG] and video monitoring) may be necessary.