Conceptual relevance of new‐onset epilepsy

Summary The definitions of “first seizure” and “new‐onset epilepsy” are arbitrary and rather simple for use to describe the beginning of a complex brain disease in which seizures are only one symptom. A diligent study of early stages in epilepsy including detailed clinical information, psychiatric comorbidities, sophisticated advanced neuroimaging, and timely functional brain tests may provide a better understanding of epileptogenesis. The goal will be to understand the process of evolution to chronic epilepsy and eventually to prevent refractory epilepsy.