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Conditions Commonly Misdiagnosed as Epilepsy
Wed, 02/17/2010 - 11:34
Having a seizure doesn’t automatically mean you have epilepsy. And without testing, the diagnosis – or misdiagnosis – can be pretty scary. There are loads of conditions that have symptoms similar to epilepsy. Here are the most common…
These isolated seizures are not rare events — up to 5 percent of people in the United States may experience a first seizure that isn't due to fever or epilepsy.
A first seizure typically occurs before age 25, with most taking place in those younger than 15. First seizures seem to strike males a little more often than females, and they may not have a specific or detectable cause. However, a first seizure can affect part of or the entire brain.
Febrile Seizures -- These seizures are caused by high fevers, and occur most commonly in infants and young children. Febrile seizures are quite common, affecting 1 in 25 children. The chances of having another febrile seizure are 25% to 30%.
While frightening, these seizures don't cause brain damage or otherwise harm children.Febrile seizures typically strike when a child is between 6 months and 5 years old, but they most often occur during the toddler years. These types of seizures may recur during childhood but are usually outgrown.
Nonepileptic Seizure Disorder (NESD) -- Nonepileptic events look like seizures, but actually are not. Conditions that may cause nonepileptic events include narcolepsy (a sleep disorder which causes reoccurring need of sleep during the day), Tourette's syndrome (a neurological condition characterized by vocal and body tics), abnormal heart rhythms (arrhythmias) and other medical conditions with symptoms that resemble seizures.
Because symptoms of these disorders can look very much like epileptic seizures, they are often mistaken for epilepsy.
Distinguishing between true epileptic seizures and nonepileptic events can be very difficult and requires a thorough medical assessment, careful monitoring, and knowledgeable health professionals.
Improvements in brain scanning and monitoring technology will hopefully improve diagnosis of nonepileptic events in the future.
When someone appears to have seizures, even though their brains show no seizure activity, they are diagnosed as having pseudo seizures which basically means they look like a seizure but aren’t one.
Seizures that are psychological in origin are often called psychogenic seizures. These seizures are most likely triggered by emotional stress or trauma. Some people with epilepsy have psychogenic seizures in addition to their epileptic seizures. It's a legitimate seizure and should be treated that way, but it is not caused by a problem in the brain.
Then there are physiologic non-epileptic seizures which can be triggered by some sort of change in the brain — typically a change in the supply of blood or oxygen rather than electrical activity.
It’s important to differentiate a seizure from that of a behavioral disorder, but it’s difficult.
Mood changes and behavioral symptoms also make a misdiagnosis of bipolar disorder possible.
Eclampsia -- Eclampsia is a dangerous condition suffered by pregnant women. The symptoms include seizures and a sudden rise in blood pressure. A pregnant woman who has an unexpected seizure should be taken to the hospital immediately.
Eclampsia occurs in about 1 out of every 2,000 to 3,000 expectant women. The seizures cause convulsions or changes in personality such as agitation. After the eclampsia is treated and after the woman has the baby, she usually won’t have any more seizures or develop epilepsy.
Viral infections usually clear up without treatment, but bacterial infections are extremely dangerous and can lead to brain damage and even death. Symptoms of meningitis include fever and chills, severe headache, vomiting, and stiff neck.
Encephalitis -- Encephalitis is an inflammation of the brain and is usually caused by a viral infection. Symptoms include fever, headache, vomiting, confusion, and stiff neck.
Migraine -- Migraine is a type of headache thought to be caused, in part, by a narrowing of blood vessels in the head and neck, which reduces the flow of blood to the brain.
People who have migraines may also have auras and other symptoms, including dizziness, nausea, and vomiting. Certain conditions may bring about a migraine, including allergies, menstrual periods, and muscle tension.
Some foods, including red wine, chocolate, nuts, caffeine, and peanut butter, can also cause a migraine.
Sleep Disorders -- According to the Cleveland Clinic, about 75% of the adult population in the
Brain Injury -- Although the symptoms of severe brain injury are hard to miss, it is less clear for milder injuries, or even those causing a mild concussion. The condition goes by the name of "mild traumatic brain injury" (MTBI). Symptoms can be mild, and can continue for days or weeks after the injury.
Post-concussive brain injury is also often misdiagnosed. A study found that soldiers who had suffered a concussive injury in battle often were misdiagnosed on their return. A variety of symptoms can occur in post-concussion syndrome and these were not being correctly attributed to their concussion injury.
In addition, a brain tumor or an infection in the brain, can be mistaken for epilepsy.
Cardiac Disorders -- EEGs alone may not clearly distinguish epilepsy from cardiac disorders. Numerous studies point to a connection between SUDEP, Unexplained Death in Epilepsy and cardiac problems.
More extensive evaluation by a cardiologist can help identify cardiac disorders which may be an underlying cause of an individual's seizures.
TIAs -- Transient Ischemia Attacks are caused by a sudden diminished blood flow in some areas of the brain that may be stroke related. Seizure-like symptoms may include changes in consciousness, speech or vision problems.
Failed Drug Therapy -- If trials of different anti-seizure medications fail, it could be because the cause of the seizures is not epilepsy.
EEGs -- EEGs alone are not sufficient to make a definite diagnosis of epilepsy. It is not a sensitive enough to distinguish many disorders which cause epileptic seizures.
When anticonvulsants don't control seizures or there is a question about the diagnosis of epilepsy, the neurologist, patient, or care giver must seek further evaluation to find the underlying cause of the seizures.
Simple Mistakes -- And then, of course, there is the element of human error. Changes in metabolism – such as low blood sugar -- from health conditions like kidney and liver problems can present as a seizure.
Drug use or withdrawal from alcohol can be construed as epilepsy. A congenital health problem, like down's syndrome, stroke or alzheimer's disease may be misdiagnosed.
The bottom line? Make sure you have a good neurologist or epileptologist…get thorough testing…keep a seizure diary…and be pro-active.
Resources:
http://www.everydayhealth.com/epilepsy/understanding/when-are-seizures-not-epilepsy.aspx
http://www.webmd.com/epilepsy/conditions-similar-to-epilepsy
http://epilepsy.suite101.com/article.cfm/epilepsymisdiagnosis_is_common
http://www.wrongdiagnosis.com/e/epilepsy/misdiag.htm#misdiagnote
Re: Conditions Commonly Misdiagnosed as Epilepsy
Submitted by pgd on Wed, 2010-02-17 - 12:49
Conditions Commonly Misdiagnosed as Epilepsy include:
Central Auditory Processing Disorder (CAPD)(subtle hearing difficulty)
www.nidcd.nih.gov/health/voice/auditory.htm - http://kidshealth.org/parent/medical/ears/central_auditory.html
ADHD Inattentive - http://www.ninds.nih.gov/disorders/adhd/adhd.htm
Conditions Commonly Misdiagnosed as Epilepsy include:
Central Auditory Processing Disorder (CAPD)(subtle hearing difficulty)
www.nidcd.nih.gov/health/voice/auditory.htm - http://kidshealth.org/parent/medical/ears/central_auditory.html
ADHD Inattentive - http://www.ninds.nih.gov/disorders/adhd/adhd.htm