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  challenges in treang epilepsy in the seng of medical c Dr. Osama F. El-Deeb Neurology Unit   Epilepsy is defned as a disorder o the brain characterized by an enduring predisposion to epilepc seizures  It is a heterogenous condion characterized by mulple possible seizure types and syndromes, diverse eologies, and variable prognoses. Accurate classifcaon is essenal or several reasons  Seizure —  A seizure represents the clinical expression of abnormal, excessive, synchronous discharges of neurons residing primarily in the cerebral cortex. This abnormal paroxysmal activity is intermittent and usually self-limited, lasting seconds to a few minutes.  On electroencephalography, a seizure ictus is characterized by sustained, abnormal electrical activity that has a relatively discrete beginning and end, and goes through an evolution characterized by changing morphology and amplitude (voltage) of the abnormal discharges.   A focal seizure has a restricted regional onset followed by spread to neighboring or remote brain regions. It may spread to deep subcortical regions and evolve to a bilateral tonic-clonic seizure (previously referred to as a secondarily generalized seizure, to differentiate it from seizures that are generalized from the onset)  focal seizure without impairment of awareness (previously referred to as simple partial seizure).  Focal seizures with impaired awareness correspond to what have previously been called complex partial seizures Impaired awareness is defined as the inability to respond normally to exogenous stimuli by virtue of altered awareness and/or responsiveness. "Complex" does not refer to the behavior per se, a mistake made by many physicians when describing a focal seizure.
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