The diagnosis of epileptic and non-epileptic seizures

Kotsopoulos, Irene A.W.; Krom, M.C.T.F.M. de; Kessels, Fons; Lodder, J.; Troost, J.; Twellaar, Mascha; Merode, Tiny van; Knottnerus, André

doi:10.1016/j.eplepsyres.2003.10.014

Cited by 58 publications

(41 citation statements)

References 12 publications

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“…People with epilepsy are treated with anti-epileptic drugs, and people with PNES may benefit from psychotherapy. Despite advances in biomedical technologies, interictal tests such as brain magnetic resonance imaging (MRI) and electroencephalogram (EEG) have inadequate specificity and sensitivity in this setting [8][9]. The diagnostic "gold standard", the video-electroencephalographic recording (video-EEG) of a typical seizure can be difficult to access, or its use may not be feasible because of the low frequency of attacks [10].…”

Section: Introductionmentioning

confidence: 99%

The role of companions in outpatient seizure clinic interactions: A pilot study

Robson

Drew

Reuber

2016

Epilepsy & Behavior

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Section: Introductionmentioning

confidence: 99%

The role of companions in outpatient seizure clinic interactions: A pilot study

Robson

Drew

Reuber

2016

Epilepsy & Behavior

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“…The absence of confusion argues in favor of a diagnosis of syncope 8 . Antecedent palpitations are more strongly associated with syncope than with seizure.…”

Section: Discussionmentioning

confidence: 99%

A 26-Year-Old Woman with Recurrent Loss of Consciousness

2011

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The case of a 26-year-old woman with congenital long QT syndrome and recurrent arrhythmic syncope which had been misdiagnosed as a seizure disorder is presented. Useful criteria for discriminating between loss of consciousness due to congenital long QT syndrome and loss of consciousness caused by seizure activity are discussed. The multiple potential causes and clinical implications of a prolonged QT interval, as well as the clinical features and management of congenital long QT syndrome are reviewed. CASEA 26-year-old woman presented to a general cardiology clinic with a chief complaint of palpitations. The palpitations had begun a few months prior and had been occurring with increased frequency in recent weeks. She characterized the episodes as a rapid heartbeat that alternated between a regular and irregular rhythm. She denied associated symptoms of chest discomfort or shortness of breath, but did experience lightheadedness. The palpitations lasted 30-60 seconds and occurred once or twice a week over the preceding two months. They seemed to occur at any time of day and without regard to physical activity, stress, or anything else she could identify. They had on occasion awakened her from sleep.Her past medical history was notable for dyslexia and a complex-partial seizure disorder. She had a history of five seizures: a first seizure at age 15, a second at age 18, and a third at age 20, at which point carbamazepine treatment was initiated. Computed tomography and magnetic resonance imaging of the head was normal. An electroencephalogram was normal as well. Ten months previously carbamazepine was discontinued because she had been free of seizures for several years. However, about two weeks prior to her cardiology appointment she had a fourth seizure, and treatment with topiramate was initiated. She had a fifth seizure a few days prior to her cardiology appointment.The seizures always occurred when she was in a state between sleeping and wakefulness and were always precipitated by a loud noise, such as a ringing telephone. She experienced a prodrome of anxiety, lightheadedness and tachycardia. She would hyperventilate prior to losing consciousness. These events were witnessed by her mother, a registered nurse, who noted tonic and focal twitching movements of her daughter. Her mother also reported that her daughter was sometimes incontinent of urine and generally unresponsive for a few minutes during these episodes. When her daughter awakened she was immediately alert and did not feel fatigued or confused.Family history was significant for premature coronary disease in her father, who had undergone coronary artery bypass grafting at 45 years of age. There was no family history of sudden death. Her only medication was topiramate 50 milligrams by mouth twice a day. She did not smoke tobacco, use any illicit drugs, or drink alcohol. She was an art student at a nearby university.Her heart rate was 94 beats per minute and her blood pressure was 118/64 mm Hg. She was a very pleasant, slender young woman. The physical ...

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“…PNES are thought to have psychological causes [1]. It has been estimated that around 12-18% of patients newly presenting with seizures may have PNES [2]. Patients with PNES are a clinically heterogeneous group [3].…”

Section: Introductionmentioning

confidence: 99%

Understanding patient perceptions following a psycho-educational intervention for psychogenic non-epileptic seizures

Baxter

Mayor

Baird

et al. 2012

Epilepsy & Behavior

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This study formed part of an evaluation of a brief educational intervention for patients with psychogenic nonepileptic seizures (PNES). The sessions provide information, seizure control techniques and management planning. The qualitative component of the research reported here aimed to provide insight into the perceptions of participants following the intervention.Semi-structured interviews were conducted with twelve patients. Interviews were taperecorded, transcribed and analysed using principles of thematic analysis. Six key themes were identified: getting answers; understanding the link with emotions; seeking a physiological explanation; doubting the diagnosis; the role of medication; and finding a way forward. The findings highlight considerable individual variation in response, with evidence of changed perceptions or enhanced understanding in some patients whilst others continued to seek answers or explanations about the cause of their seizures. There were no clear links between reported improved understanding or acceptance of the diagnosis, and a perceived improvement in the condition.

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The diagnosis of epileptic and non-epileptic seizures

Cited by 58 publications

References 12 publications

The role of companions in outpatient seizure clinic interactions: A pilot study

The role of companions in outpatient seizure clinic interactions: A pilot study

A 26-Year-Old Woman with Recurrent Loss of Consciousness

Understanding patient perceptions following a psycho-educational intervention for psychogenic non-epileptic seizures

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