epileptic vs. non-epileptic seizure: what are the signs?

7 May

WHAT ARE THE SIGNS?

review by Avbersek & Sisodiya in J Neurol Neurosurg Psychiatry (link below)
–looked at 34 studies
–tried to tease out what signs distinguish epileptic vs. non-epileptic seizure

WHAT DID THEY FIND?

–signs that favor psychogenic non-epileptic seizures (specificity)

  • fluctuating course (96%)
  • asynchronous movements (93-96%)
  • pelvic thrusting (96-100%)
  • side-to-side head/body movement (96-100%)
  • closed eyes (74-100%)
  • ictal crying (100%)
  • memory recall (96%)

–signs that favor epileptic seizures (specificity)

  • occurance from sleep (100%)
  • post-ictal confusion (88%)
  • stertorous (snoring) breathing (100%)

FYI:
–the sensitivities for all of these signs were horrible, so can’t use them to rule anything out
–sometimes excluded frontal lobe partial seizures
–insufficient evidence: gradual onset, flailing/thrasing, opisthotonus, tongue biting, urinary incontinence

Reference(s): review article, picture

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