Seizure differential diagnosis
|
Seizure Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Seizure differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Seizure differential diagnosis |
|
Risk calculators and risk factors for Seizure differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Differentiating Seizure from other Conditions
It can be difficult to distinguish a seizure from other conditions causing a collapse, abnormal movements or other seizure manifestations. A 2007 evidence-based review from the American Academy of Neurology and the American Epilepsy Society recommends an electroencephalogram (EEG, brain wave activity) and brain imaging with CT scan or MRI scan in the work-up of adults presenting with a first apparently unprovoked seizure. Blood tests, lumbar puncture or toxicology screening can be helpful in specific circumstances suggestive of an underlying cause like meningitis or drug overdose, but there is insufficient evidence to support their routine use in the work-up of an adult with an apparently unprovoked first seizure.[1]
Differentiating a seizure from other conditions such as syncope can be difficult. In addition, 5% of patients with a positive tilt table test may have seizure-like activity that seems to be due to cerebral hypoxia.[2]
As seizures have a differential diagnosis, it is common for patients to be simultaneously investigated for cardiac and endocrine causes. Checking glucose levels, for example, is a mandatory action in the management of seizures as hypoglycemia may cause seizures, and failure to administer glucose would be harmful to the patient. Other causes typically considered are syncope and cardiac arrhythmias, and occasionally, panic attacks and cataplexy. For more information, see non-epileptic seizures.
Neurosyphilitic disease can present with seizures and must be differentiated from other causes of seizures.[3]
References
- ↑ Krumholz A, Wiebe S, Gronseth G, Shinnar S, Levisohn P, Ting T, Hopp J, Shafer P, Morris H, Seiden L, Barkley G, French J; Quality Standards Subcommittee of the American Academy of Neurology; American Epilepsy Society. Practice Parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology 2007; 69(21): 1996-2007. PMID 18025394
- ↑ Passman R, Horvath G, Thomas J; et al. (2003). "Clinical spectrum and prevalence of neurologic events provoked by tilt table testing". Arch. Intern. Med. 163 (16): 1945–8. doi:10.1001/archinte.163.16.1945. PMID 12963568.
- ↑ Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.