Aims:To determine the proportion of children admitted with difficult to treat paroxysmal events to a tertiary epilepsy centre who did not have epilepsy.Methods:In an observational retrospective study,all case notes of...Aims:To determine the proportion of children admitted with difficult to treat paroxysmal events to a tertiary epilepsy centre who did not have epilepsy.Methods:In an observational retrospective study,all case notes of 223 children admitted in 1997 were examined.The referral was made from the local paediatric department in 51%of cases,other departments in 27%,and from general or specialist practitioners in 22%.Doubt regarding the diagnosis of epilepsy was expressed in the referral note in 17%.On admission,86%were on antiepileptic drug treatment.During admission all children were subjected to a comprehensive intensive observation and 62%had EEG monitoring.Results:In total,39%(87/223)were found not to have epilepsy.In 30%of children(55/184)referred without any doubts about the epilepsy diagnosis,the diagnosis was disproved.Of the 159 children admitted for the first time,75(47%)were discharged with a diagnosis of non-epileptic seizures.Of 125 children admitted for the first time with no doubts about the diagnosis of epilepsy,44(35%)did not have epilepsy.Staring episodes were the most frequently encountered non-epileptic paroxysmal event.Psychogenic non-epileptic seizures were found in 12 children.A total of 34(15%)had their medication tapered off;a further 22(10%)had tapered off medication before admission.Conclusion:The present study supports the view that misdiagnosis of epilepsy is common.The treating physician should be cautious in diagnosis,especially of staring episodes.A diagnostic re-evaluation should be undertaken in difficult cases with continuing paroxysmal events in order to avoid unnecessary drug treatment and restrictions on the child’s lifestyle.展开更多
文摘Aims:To determine the proportion of children admitted with difficult to treat paroxysmal events to a tertiary epilepsy centre who did not have epilepsy.Methods:In an observational retrospective study,all case notes of 223 children admitted in 1997 were examined.The referral was made from the local paediatric department in 51%of cases,other departments in 27%,and from general or specialist practitioners in 22%.Doubt regarding the diagnosis of epilepsy was expressed in the referral note in 17%.On admission,86%were on antiepileptic drug treatment.During admission all children were subjected to a comprehensive intensive observation and 62%had EEG monitoring.Results:In total,39%(87/223)were found not to have epilepsy.In 30%of children(55/184)referred without any doubts about the epilepsy diagnosis,the diagnosis was disproved.Of the 159 children admitted for the first time,75(47%)were discharged with a diagnosis of non-epileptic seizures.Of 125 children admitted for the first time with no doubts about the diagnosis of epilepsy,44(35%)did not have epilepsy.Staring episodes were the most frequently encountered non-epileptic paroxysmal event.Psychogenic non-epileptic seizures were found in 12 children.A total of 34(15%)had their medication tapered off;a further 22(10%)had tapered off medication before admission.Conclusion:The present study supports the view that misdiagnosis of epilepsy is common.The treating physician should be cautious in diagnosis,especially of staring episodes.A diagnostic re-evaluation should be undertaken in difficult cases with continuing paroxysmal events in order to avoid unnecessary drug treatment and restrictions on the child’s lifestyle.
