Neurol. praxi. 2010;11(5):312-316
Diagnostic and indication errors in epilepsy treatment
- Neurologické oddělení Nemocnice Na Homolce, Praha
Diagnostic and indication errors are analysed. Differential diagnoses between epileptic and organic non-epileptic seizures comprise
syncopes, myoclonus, extrapyramidal disorders, transient global amnesia, metabolic and endocrine breakdown, and parasomnias.
Syncopes often present with motor symptoms – myoclonic jerks, tonic limb extension or flection, orofacial movements, and open eyes.
Cortical provoked myoclonus is encountered in encephalopaties. Paroxysmal kinesigenic dyskinesias constitute a serious diagnostic
problem. Symptoms of transient global amnesia may be caused by non-convulsive epileptic status. Differences between nocturnal frontal
lobe seizures and parasomnias are thoroughly discussed. Main indication errors are: late referrals to epilepsy centers, not performing
complex re-evaluation in resistant patients after 4–6 years, and belated vagus nerve stimulator indication.
Keywords: epilepsy, syncope, myoclonus, paroxysmal kinesigenic dyskinesia, transient global amnesia, parasomnia
Published: December 1, 2010 Show citation
References
- Colivicchi F, Ammirati F, Melina D, Guido V, Imperoli G, Santini M. Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score. 2003; Eur Heart J.; 24: 811-819.
- Derry Ch, Davey M, Johns M, Kron K, Glencross D, Marini C, Scheffer IE, Berkovic SF. Distinguishing Sleep Disorders from Seizures. 2006; Arch. Neurol. 63: 705-709.
Go to original source... 
Go to PubMed... - Kanner A. Common Errors Made in the Diagnosis and Treatment of Epilepsy. 2008; Seminars in Neurology 28(03): 364-378. Go to original source... Go to PubMed...
- Komárek V. Epileptické a neepileptické záchvaty v dospívání. 2008; Neurol. pro praxi 9(6): 334-338.
- Kuba R. Frontální a psychogenní záchvaty - diferenciálně diagnostický problém Neurol. pro praxi 2001; 4: 210-212.
- Liang JF, Shen AL, Lin SK. Bilateral hippocampal abnormalities on diffusion-weighted MRI in transient global amnesia: report of a case. 2009; Acta Neurol Taiwan; 18(2): 127-129. Go to PubMed...
- Mink JW. The paroxysmal dyskinesias. 2007; Current Opin Pediatr 19: 652-656. Go to original source... Go to PubMed...
- Strupp M, Bruning R, Wu RH, Deimling M, Reiser M, Brandt T. Diffusion-weighted MRI in transient global amnesia: elevated signal intensity in the left mesial temporal lobe in 7 of 10 patients. 1998; Ann Neurol 43(2): 164-170. Go to original source... Go to PubMed...
- Unterberger I, Trinka E. Review: Diagnosis and Treatment of Paroxysmal Dyskinesias Revisited; Ther Adv Neurol Disorders. 2008; 1(2): 67-74. Go to original source... Go to PubMed...
- Vojtěch Z. Klinická elektroencefalografie v epileptologii 2008; Neurol. pro praxi 2008; 9(2): 69-74.
- Vyhnálek M, Bojar M, Jerabek J, Hort J. Long lasting recurrent familiar transient global amnesia after betablocker treatment withdrawal: case report. 2008; Neuro Endocrinol Lett.; 29(1): 44-46. Go to PubMed...
- Winbeck K, Etgen T, von Einsiedel HG, Röttinger M, Sander D. DWI in transient global amnesia and TIA: proposal for an ischaemic origin of TGA. 2005; J Neurol Neurosurg Psychiatry; 76(3): 438-441. Go to original source... Go to PubMed...