000 02455cam a2200265 4500500
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041 _afre
042 _adc
100 1 0 _aLeibetseder, Annette
_eauthor
700 1 0 _a Eisermann, Monika
_eauthor
700 1 0 _a LaFrance Jr, W. Curt
_eauthor
700 1 0 _a Nobili, Lino
_eauthor
700 1 0 _a von Oertzen, Tim J.
_eauthor
245 0 0 _aHow to distinguish seizures from non-epileptic manifestations
260 _c2020.
500 _a71
520 _aThe first and most important step in establishing diagnosis of epilepsy consists of careful history taking from patients and witnesses. The clinical evaluation of the event will lead the indication for further diagnostic tests including e.g. EEG and MRI. Hence, identifying the paroxysmal event as epileptic or non-epileptic is the very first step in the diagnostic process. Paroxysmal events pose a clinical challenge, as these are unpredictable and do not usually occur in the doctor's office. History taking, hunting for witness reports and home-video recordings are the main tools to conclude whether a paroxysmal event is a seizure or not. In this review, we describe the most common differential diagnoses of epileptic seizures, including syncope, psychogenic non-epileptic seizures, as well as a variety of paroxysmal conditions and behaviours of all age groups. Misdiagnosis of non-epileptic events as epilepsy may not only defer the correct diagnosis and treatment but also poses additional risk by prescribing antiepileptic drugs unnecessarily. Moreover, missing the diagnosis of epilepsy implies risk of additional seizures and therefore possibly injuries, sudden death in people with epilepsy, or status epilepticus. Studies have shown that patient and witness accounts are unreliable in a high percentage of cases. Therefore, the core competency of doctors and medical professionals assessing paroxysmal events is knowledge of the clinical features that help define the different aetiologies, thus empowering them to establish the most accurate appraisal of an event. [Published with video sequences].
690 _aepileptic seizures
690 _asigns and symptoms
690 _amigraine
690 _anon-epileptic seizures
690 _asyncope
786 0 _nEpileptic Disorders | Vol 22 | 6 | 2020-06-01 | p. 716-738 | 1294-9361
856 4 1 _uhttps://shs.cairn.info/revue-epileptic-disorders-2020-6-page-716?lang=en&redirect-ssocas=7080
999 _c611434
_d611434