Epilepsy differential diagnosis: Difference between revisions
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* Organic conditions: | * Organic conditions: | ||
** Hypoglycemia | ** Hypoglycemia | ||
** Panic attacks: Panic attacks mostly resemble PNEAs rather than epilepsy. | ** Panic attacks: Panic attacks mostly resemble PNEAs rather than epilepsy.<ref name="pmid10767885">{{cite journal |vauthors=Merritt TC |title=Recognition and acute management of patients with panic attacks in the emergency department |journal=Emerg. Med. Clin. North Am. |volume=18 |issue=2 |pages=289–300, ix |date=May 2000 |pmid=10767885 |doi= |url=}}</ref><ref name="pmid7988943">{{cite journal |vauthors=Vein AM, Djukova GM, Vorobieva OV |title=Is panic attack a mask of psychogenic seizures?--a comparative analysis of phenomenology of psychogenic seizures and panic attacks |journal=Funct. Neurol. |volume=9 |issue=3 |pages=153–9 |date=1994 |pmid=7988943 |doi= |url=}}</ref> In mesiotemporal epilepsy the patient experience fear as an aura and it can be mistaken with panic attack specially if the typical seizure doesn’t happen after aura.<ref name="pmid11160466">{{cite journal |vauthors=Biraben A, Taussig D, Thomas P, Even C, Vignal JP, Scarabin JM, Chauvel P |title=Fear as the main feature of epileptic seizures |journal=J. Neurol. Neurosurg. Psychiatry |volume=70 |issue=2 |pages=186–91 |date=February 2001 |pmid=11160466 |pmc=1737203 |doi= |url=}}</ref> | ||
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Overview
Differentiating [Disease name] from other Diseases
Epilepsy must be differentiated from:
- Psychogenic nonepileptic attacks (PNEAs):
- These patients are resistance to anti epileptic drugs.[4]
- PNEAs rarely happens in sleep and mostly happens in the present of an audience.[5]
- In physical examination of PNEAs patients we can observe histrionic features.[6]
- Tongue biting, urine incontinence and postictal confusion are in favor of epilepsy.[6]
- In PNEAs we have normal EEGs.[7]
- Syncope:
- Syncope is another misdiagnosed disease with epilepsy. The reason for this misdiagnosis is that syncope attacks happens in a convulsive manner and patients may have body jerks and clonic movement.[8]
- Syncope also cause EEG changes and make it more difficult to differentiate it from epilepsy.[9]
- There are some presyncope symptoms such as sweating, dizziness, nausea and malaise which helps us differentiate it from epilepsy.[10]
- Organic conditions:
References
- ↑ Benbadis SR, O'Neill E, Tatum WO, Heriaud L (September 2004). "Outcome of prolonged video-EEG monitoring at a typical referral epilepsy center". Epilepsia. 45 (9): 1150–3. doi:10.1111/j.0013-9580.2004.14504.x. PMID 15329081.
- ↑ Behrouz R, Heriaud L, Benbadis SR (May 2006). "Late-onset psychogenic nonepileptic seizures". Epilepsy Behav. 8 (3): 649–50. doi:10.1016/j.yebeh.2006.02.003. PMID 16531122.
- ↑ Duncan R, Oto M, Martin E, Pelosi A (June 2006). "Late onset psychogenic nonepileptic attacks". Neurology. 66 (11): 1644–7. doi:10.1212/01.wnl.0000223320.94812.7a. PMID 16769934.
- ↑ Benbadis SR (1999). "How many patients with pseudoseizures receive antiepileptic drugs prior to diagnosis?". Eur. Neurol. 41 (2): 114–5. doi:10.1159/000008015. PMID 10023117.
- ↑ Benbadis SR, Lancman ME, King LM, Swanson SJ (July 1996). "Preictal pseudosleep: a new finding in psychogenic seizures". Neurology. 47 (1): 63–7. PMID 8710126.
- ↑ 6.0 6.1 Benbadis SR, Wolgamuth BR, Goren H, Brener S, Fouad-Tarazi F (November 1995). "Value of tongue biting in the diagnosis of seizures". Arch. Intern. Med. 155 (21): 2346–9. PMID 7487261.
- ↑ Davis BJ (2004). "Predicting nonepileptic seizures utilizing seizure frequency, EEG, and response to medication". Eur. Neurol. 51 (3): 153–6. doi:10.1159/000077287. PMID 15017116.
- ↑ Aminoff MJ, Scheinman MM, Griffin JC, Herre JM (June 1988). "Electrocerebral accompaniments of syncope associated with malignant ventricular arrhythmias". Ann. Intern. Med. 108 (6): 791–6. PMID 3369769.
- ↑ Sheldon RS, Koshman ML, Murphy WF (June 1998). "Electroencephalographic findings during presyncope and syncope induced by tilt table testing". Can J Cardiol. 14 (6): 811–6. PMID 9676166.
- ↑ Sheldon R, Rose S, Ritchie D, Connolly SJ, Koshman ML, Lee MA, Frenneaux M, Fisher M, Murphy W (July 2002). "Historical criteria that distinguish syncope from seizures". J. Am. Coll. Cardiol. 40 (1): 142–8. PMID 12103268.
- ↑ Merritt TC (May 2000). "Recognition and acute management of patients with panic attacks in the emergency department". Emerg. Med. Clin. North Am. 18 (2): 289–300, ix. PMID 10767885.
- ↑ Vein AM, Djukova GM, Vorobieva OV (1994). "Is panic attack a mask of psychogenic seizures?--a comparative analysis of phenomenology of psychogenic seizures and panic attacks". Funct. Neurol. 9 (3): 153–9. PMID 7988943.
- ↑ Biraben A, Taussig D, Thomas P, Even C, Vignal JP, Scarabin JM, Chauvel P (February 2001). "Fear as the main feature of epileptic seizures". J. Neurol. Neurosurg. Psychiatry. 70 (2): 186–91. PMC 1737203. PMID 11160466.