Differential diagnosis of epilepsy

CONTINUUM Lifelong Learning in Neurology

Volumn 13, Issue 4 EPILEPSY, 2007, Pages 48-70

  Benbadis, Selim R ^a,b  

^a UNIVERSITY OF SOUTH FLORIDA   (United States)

^b TAMPA GENERAL HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; CASE REPORT; CLINICAL FEATURE; DIAGNOSTIC ERROR; ELECTROENCEPHALOGRAM; EPILEPSY; FEMALE; HEALTH PRACTITIONER; HUMAN; MALE; MENTAL DISEASE; MENTAL HEALTH; MIGRAINE; MOTOR DYSFUNCTION; NEUROLOGIC DISEASE; REVIEW; SYNCOPE; TRANSIENT GLOBAL AMNESIA;

EID: 34548441142     PISSN: 10802371     EISSN: None     Source Type: Journal    
DOI: 10.1212/01.CON.0000284534.43272.1c     Document Type: Review

References (42)

1. ▶ American Psychiatric Association. Healthy minds. Healthy lives. http://www.healthyminds.org/. Accessed November 6, 2006. The patient education section of the American Psychiatric Association Web site, where surprisingly no information whatsoever is included on psychogenic seizures, psychogenic symptoms, somatoform disorders, somatization, factitious disorder, etc.
2. ▶ Aminoff MJ, Scheinman MM, Griffin JC, Herre JM. Electrocerebral accompaniments of syncope associated with malignant ventricular arrhythmias. Ann Intern Med 1988;108(6):791-796. A good study showing the EEG findings in syncope and emphasizing the frequency with which syncope is "convulsive. "
3. ▶ Behrouz R, Heriaud L, Benbadis SR. Late-onset psychogenic nonepileptic seizures. Epilepsy Behav 2006;8(3):649-650. A small study on psychogenic nonepileptic seizures of late onset.
4. ▶ Benbadis SR. Provocative techniques should be used for the diagnosis of psychogenic nonepileptic seizures. Arch Neurol 2001;58(12):2063- 2065. A discussion that addresses the controversy of whether inductions should be used. This is the pro side; see Gates, 2001, for the con side.
5. ▶ Benbadis SR. The problem of psychogenic symptoms: is the psychiatric community in denial? Epilepsy Behav 2005a;6(1):9-14. A review and discussion of psychogenic symptoms in general and why they are such a challenging area of medicine.
6. ▶ Benbadis SR. A spell in the epilepsy clinic and a history of ''chronic pain'' or "fibromyalgia" independently predict a diagnosis of psychogenic seizures. Epilepsy Behav 2005b;6(2):264-265. A study of two recently identified predictors of psychogenic nonepileptic seizures, each with a 75% positive predictive value.
7. ▶ Benbadis SR. Hypergraphia and the diagnosis of psychogenic attacks. Neurology 2006a;67(5):904. A case report with a neuroimage showing a good example of florid review of systems that suggests somatization.
8. ▶ Benbadis SR. Psychogenic non-epileptic seizures. In: Wyllie E, editor. The treatment of epilepsy: principles and practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2006b;623-630. A comprehensive review of psychogenic nonepileptic seizures.
9. ▶ Benbadis SR. The EEG in nonepileptic seizures. J Clin Neurophysiol 2006c;23(4):340-352. A review, with illustrations, of interictal and ictal misleading EEG patterns that can contribute to the misdiagnosis of epilepsy.
10. ▶ Benbadis SR, Agrawal V, Tatum WO 4th. How many patients with psychogenic nonepileptic seizures also have epilepsy? Neurology 2001;57(5): 915-917. A study of how often good evidence for epilepsy is found in patients with psychogenic nonepileptic seizures (answer: about 10%).
11. ▶ Benbadis SR, Blustein JN, Sunstad L. Should patients with psychogenic nonepileptic seizures be allowed to drive? Epilepsia 2000a;41(7):895-897. The only data available to date on the risk of motor vehicle accidents in patients with psychogenic nonepileptic seizures.
12. ▶ Benbadis SR, Chichkova R. Psychogenic pseudosyncope: an underestimated and provable diagnosis. Epilepsy Behav 2006;9(1):106-110. An original study of psychogenic pseudosyncope proven by EEG-video recordings.
13. ▶ Benbadis SR, Johnson K, Anthony K, et al. Induction of psychogenic nonepileptic seizures without placebo. Neurology 2000b;55(12):1904-1905. A study of the yield of inductions without placebo, using hyperventilation, photic stimulation, and verbal suggestion.
14. ▶ Benbadis SR, Lancman ME, King LM, Swanson SJ. Preictal pseudosleep: a new finding in psychogenic seizures. Neurology 1996;47(1):63-67. A newly described symptom that has a strong association with psychogenic nonepileptic seizures.
15. ▶ Benbadis SR, Siegrist K, Tatum WO, et al. Short-term outpatient EEG video with induction in the diagnosis of psychogenic seizures. Neurology 2004;63(9):1728-1730. A study that describes the use of inductions as part of a short-term outpatient EEG-video recording, showing a yield of about 70% when the clinical suspicion is high.
16. ▶ Benbadis SR, Tatum WO. Overintepretation of EEGs and misdiagnosis of epilepsy. J Clin Neurophysiol 2003;20(1):42-44. A study of commonly overread EEG patterns, showing that most errors (overread EEGs) are due to nonspecific temporal sharply contoured wicketlike waveforms.
17. ▶ Benbadis SR, Wolgamuth BR, Goren H, et al. Value of tongue biting in the diagnosis of seizures. Arch Intern Med 1995;155(21):2346-2349. A study documenting the high specificity of lateral tongue lacerations for the diagnosis of seizures.
18. ▶ Bergen D, Ristanovic R. Weeping as a common element of pseudoseizures. Arch Neurol 1993;50(10):1059-1060. A study documenting the high specificity and usefulness of ictal weeping for the diagnosis of psychogenic nonepileptic seizures.
19. ▶ Biraben A, Taussig D, Thomas P, et al. Fear as the main feature of epileptic seizures. J Neurol Neurosurg Psychiatry 2001;70(2):186-191. A study of intense fear as the main ictal symptom, mostly found in temporal lobe epilepsy.
20. ▶ Blume WT, Kaibara M, Young GB. Atlas of adult electroencephalography. Philadelphia: Lippincott Williams & Wilkins, 2001;4-172. An excellent discussion of nonspecific temporal sharp transients that are frequently mistaken for epileptiform discharges.
21. ▶ Bye AM, Kok DJ, Ferenschild FT, Vles JS. Paroxysmal non-epileptic events in children: a retrospective study over a period of 10 years. J Paediatr Child Health 2000;36(3):244-248. A study documenting the wider differential diagnosis in children, with many nonepileptic but nonpsychogenic paroxysmal behaviors.
22. ▶ Carmant L, Kramer U, Holmes GL, et al. Differential diagnosis of staring spells in children: a video-EEG study. Pediatr Neurol 1996;14(3):199-202. A study of nonepileptic staring spells and common differential diagnosis of absence seizures in children.
23. ▶ Carton S, Thompson PJ, Duncan JS. Non-epileptic seizures: patients' understanding and reaction to the diagnosis and impact on outcome. Seizure 2003;12(5):287-294. A study emphasizing the impact of patient education on outcome in patients with psychogenic nonepileptic seizures.
24. ▶ Chadwick D, Smith D. The misdiagnosis of epilepsy. BMJ 2002;324(7336): 495-496. A thought-provoking discussion on the harmful effects EEGs can have when they are misused or misinterpreted.
25. ▶ Chen DK, So YT, Fisher RS; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Use of serum prolactin in diagnosing epileptic seizures: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2005;65(5):668-675.
26. ▶ Chung SS, Gerber P, Kirlin KA. Ictal eye closure is a reliable indicator for psychogenic nonepileptic seizures. Neurology 2006;66(11):1730- 1731. A recent study on an important new (and easily identified) clinical finding that suggests psychogenic nonepileptic seizures.
27. ▶ Cohen LM, Howard GF 3rd, Bongar B. Provocation of pseudoseizures by psychiatric interview during EEG and video monitoring. Int J Psychiatry Med 1992;22(2):131-140. A study of an induction technique for psychogenic nonepileptic seizures without use of a placebo.
28. ▶ Colosimo C, Bologna M, Lamberti S, et al. A comparative study of primary and secondary hemifacial spasm. Arch Neurol 2006;63(3):441-444. A review on the main features of hemifacial spasm, a differential diagnosis of focal motor seizures.
29. ▶ Cryer PE. Symptoms of hypoglycemia, thresholds for their occurrence, and hypoglycemia unawareness. Endocrinol Metab Clin North Am 1999;28(3):495-500, v-vi . A review on the main features of hypoglycemia and a differential diagnosis of generalized seizures and syncope.
30. ▶ Davis BJ. Predicting nonepileptic seizures utilizing seizure frequency, EEG, and response to medication. Eur Neurol 2004;51(3):153-156. A study of three historical red flags that help generate suspicion of a diagnosis of psychogenic nonepileptic seizures.
31. ▶ Derry CP, Davey M, Johns M, et al. Distinguishing sleep disorders from seizures: diagnosing bumps in the night. Arch Neurol 2006;63(5):705-709. A recent original study of a scale (a little cumbersome to use) that helps differentiate, by history, parasomnias from seizures.
32. ▶ Desai P, Talwar D. Nonepileptic events in normal and neurologically handicapped children: a video-EEG. Pediatr Neurol 1992;8(2):127-129. Another study documenting the wider differential diagnosis in children, with many nonepileptic but nonpsychogenic paroxysmal behaviors.
33. ▶ Devinsky O, Sato S, Kufta CV, et al. Electroencephalographic studies of simple partial seizures with subdural electrode recordings. Neurology 1989;39(4):527-533. An important study indicating that proven simple partial seizures may not have EEG manifestation on surface EEG, so that the absence of a surface ictal pattern does not, in itself, exclude a simple partial seizure.
34. ▶ Dressler D, Benecke R. Diagnosis and management of acute movement disorders. J Neurol 2005;252(11):1299-1306. A good review of movement disorders that are acute and paroxysmal and may therefore be mistaken for seizures.
35. ▶ Drury I, Beydoun A. Pitfalls of EEG interpretation in epilepsy. Neurol Clin 1993;11(4):857-881. An excellent review with illustrations of tricky EEG patterns that are commonly misinterpreted and how to identify them.
36. ▶ Eiris-Punal J, Rodriguez-Nunez A, Fernandez-Martinez N, et al. Usefulness of the head-upright tilt test for distinguishing syncope and epilepsy in children. Epilepsia 2001;42(6):709-713. An illustrative case series of children with syncope misdiagnosed as having epilepsy.
37. ▶ Frankel EA, Shalaby TM, Orenstein SR. Sandifer syndrome posturing: relation to abdominal wall contractions, gastroesophageal reflux, and fundoplication. Dig Dis Sci 2006;51(4):635-640. A review of gastroesophageal reflux and how it can mimic seizures in young children.
38. ▶ Gates JR. Provocative testing should not be used for nonepileptic seizures. Arch Neurol 2001;58(12):2065-2066. A discussion that addresses the controversy of whether inductions should be used. This is the con side; see Benbadis, 2001, for the pro side.
39. ▶ Gottlob I, Wizov SS, Reinecke RD. Spasmus nutans. A long-term follow-up. Invest Ophthalmol Vis Sci 1995;36(13):2768-2771. A case series of spasmus nutans with follow-up.
40. ▶ Guilleminault C, Gelb M. Clinical aspects and features of cataplexy. Adv Neurol 1995;67:65-77. An authoritative description of cataplexy.
41. ▶ Han SW, Kim SH, Kim JK, et al. Hemodynamic changes in limb shaking TIA associated with anterior cerebral artery stenosis. Neurology 2004;63(8): 1519-1521. One of the few papers on limb-shaking TIAs.
42. ▶ Harden CL, Burgut FT, Kanner AM. The diagnostic significance of video-EEG monitoring findings on pseudoseizure patients differs between neurologists and psychiatrists. Epilepsia 2003;44(3):453-456. An important study documenting the skepticism of psychiatrists about the diagnosis of psychogenic nonepileptic seizures.