How frequently are first adult seizures misdiagnosed?

Updated: Nov 30, 2017
  • Author: Eissa Ibrahim AlEissa, MD, MBBS; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Many diseases can cause paroxysmal clinical events. The correct diagnosis of the paroxysmal event is necessary to provide correct treatment. If the event is an epileptic seizure, the seizure type and associated clinical, electroencephalographic (EEG) (see an example in the image below), and neuroimaging findings assist in determining the risk of seizure recurrence and the possible need to begin anticonvulsant therapy. Yet, the correct diagnosis is often missed.

Scheepers et al reported 49 patients with an incorrect diagnosis and 26 patients with an uncertain diagnosis among 214 patients with a diagnosis of epilepsy. [1] In addition, about 30% of patients seen at epilepsy centers for refractory seizures turn out to have been misdiagnosed and do not have seizures. [2]

An electroencephalogram (EEG) recording of a tempo An electroencephalogram (EEG) recording of a temporal lobe seizure. The ictal EEG pattern is shown in the rectangular areas.

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