Epilepsy differential diagnosis
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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:
- Hypoglycemia
- Panic attacks: Panic attacks mostly resemble PNEAs rather than epilepsy. (44,45) 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. (46)
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.