scholarly journals Organophosphate Intoxication and Neuroradiological Features in the Differential Diagnosis of Epileptic Seizures

2021 ◽  
Author(s):  
Aydın Talip Yıldoğan
Keyword(s):  
Differential Diagnosis ◽  
Epileptic Seizures ◽  
Organophosphate Intoxication

Can conversation analytic findings help with differential diagnosis in routine seizure clinic interactions?

2016 ◽  
Vol 12 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Katie Ekberg ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Errors ◽  
Epileptic Seizures ◽  
Routine Clinical Setting ◽  
Choice Of Treatment ◽  
Transient Loss ◽  
Factual Content ◽  
Patient’S History ◽  
Linguistic Methods

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.

Epilepsy and Related Disorders

2018 ◽  
Author(s):  
Barbara Dworetzky ◽  
Jong Woo Lee
Keyword(s):  
Differential Diagnosis ◽  
Generic Drugs ◽  
Sudden Change ◽  
Epileptic Seizures ◽  
Quality Measures ◽  
The Elderly ◽  
Childhood And Adolescence ◽  
Nonepileptic Seizures ◽  
Infancy And Early Childhood ◽  
The Brain

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy.  This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures

scholarly journals Recognizing Syncope: Pitfalls and Surprises

1996 ◽  
Vol 89 (7) ◽  
pp. 372-375 ◽  
Author(s):  
T Lempert
Keyword(s):  
Creatine Kinase ◽  
Differential Diagnosis ◽  
Head Injury ◽  
Muscle Activity ◽  
Epileptic Seizures ◽  
Accurate Information ◽  
Loss Of Consciousness ◽  
Mere Presence ◽  
Key Features ◽  
Premonitory Symptoms

Loss of consciousness and falling are the key features of syncope. Common accompaniments include tonic and myoclonic muscle activity, eye deviations, automatisms, vocalizations and hallucinations which may render the distinction from epileptic seizures difficult. Differential diagnosis is based on the specific features and not the mere presence of these phenomena. Recognition of syncope depends also on accurate information about precipitants, premonitory symptoms and postictal events: the absence of postictal confusion has been identified as the single most powerful factor discriminating syncope from epileptic seizures whereas incontinence and head injury are common in both conditions. Investigations such as electroencephalogram, tilt testing and postictal prolactin or creatine kinase levels may be helpful but are never diagnostic in isolation. Exceptionally, hypoxic and epileptic mechanisms interact within a single attack.

Postictal serum creatine kinase for the differential diagnosis of epileptic seizures and psychogenic non-epileptic seizures: a systematic review

2014 ◽  
Vol 262 (2) ◽  
pp. 251-257 ◽  
Author(s):  
Francesco Brigo ◽  
Stanley C. Igwe ◽  
Roberto Erro ◽  
Luigi Giuseppe Bongiovanni ◽  
Antonio Marangi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Creatine Kinase ◽  
Differential Diagnosis ◽  
Epileptic Seizures ◽  
Serum Creatine Kinase

Using illness narratives in clinical diagnosis

2018 ◽  
pp. 203-219
Author(s):  
Elisabeth Gülich
Keyword(s):  
Differential Diagnosis ◽  
Anxiety Disorders ◽  
Clinical Diagnosis ◽  
Basic Assumption ◽  
Epileptic Seizures ◽  
Illness Narratives ◽  
Panic Attacks ◽  
Patient Interactions ◽  
Narrative Patterns ◽  
Narrative Techniques

This chapter argues that illness narratives are a suitable instrument for differential diagnosis in practice. The study discussed is based on a corpus of doctor–patient interactions, i.e., encounters with patients suffering from epileptic or non-epileptic seizures and/or anxiety disorders, and for most of whom differential diagnosis is very difficult. The basic assumption put forward here is that the types of narrative can give clues to identify the types of seizures or attacks. The focus is on the ‘methods’ patients use in verbalizing the ‘auras’ preceding the seizures and the course of the seizures or attacks themselves. In particular, it pays attention to the procedures of resolving difficulties of verbalization, which occur during the production of the narrative. It demonstrates that preferences in the choice of narrative techniques allow a distinction between patients with epileptic seizures and patients with other types of fits or with panic attacks. Finally it suggests that knowledge of recurrent narrative patterns can help to recognize the syndrome presented, on condition that the doctor encourages narrative reconstructions and listens carefully.

Epilepsy and Related Disorders

2018 ◽  
Author(s):  
Barbara Dworetzky ◽  
Jong Woo Lee
Keyword(s):  
Differential Diagnosis ◽  
Generic Drugs ◽  
Sudden Change ◽  
Epileptic Seizures ◽  
Quality Measures ◽  
The Elderly ◽  
Childhood And Adolescence ◽  
Nonepileptic Seizures ◽  
Infancy And Early Childhood ◽  
The Brain

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy.  This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures

#3079 Investigating the feasibility of automating the differential diagnosis of transient loss of consciousness

2021 ◽  
Vol 92 (8) ◽  
pp. A7.1-A7
Author(s):  
Nathan Pevy ◽  
Heidi Christensen ◽  
Traci Walker ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Random Forest ◽  
Epileptic Seizures ◽  
The Other ◽  
Future Research ◽  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Audio Recordings ◽  
Transient Loss ◽  
Nonepileptic Seizures

BackgroundThere are three common causes of Transient Loss of Consciousness (TLOC), syncope, epileptic and psychogenic nonepileptic seizures (PNES). Many individuals who have experienced TLOC initially receive an incorrect diagnosis and inappropriate treatment. Whereas syncope can be distinguished from the other two causes relatively easily with a small number of yes/no questions, the differentiation of the other two causes of TLOC is more challenging. Previous qualitative research based on the methodology of Conversation Analysis has demonstrated that epileptic and nonepileptic seizures are described differently when patients talk to clinicians about their TLOC experiences. One particularly prominent difference is that epileptic seizure descriptions are characterised by more formulation effort than accounts of nonepileptic seizures.AimThis research investigates whether features likely to reflect the level of formulation effort can be automatically elicited from audio recordings and transcripts of speech and used to differentiate between epileptic and nonepileptic seizures.MethodVerbatim transcripts of conversations between patients and neurologists were manually produced from video and audio recordings of interactions with 45 patients (21 epilepsy and24 PNES). The subsection of each transcript containing the patients account of their first seizure was manually extracted for the analysis. Seven automatically detectable features were designed as markers of formulation effort. These features were used to train a Random Forest machine learning classifier.ResultsThere were significantly more hesitations and repetitions in descriptions of first epileptic than nonepileptic seizures. Using a nested leave-one-out cross validation approach, 71% of seizures were correctly classified by the Random Forest classifier.ConclusionsThis pilot study provides proof of principle that linguistic features that have been automatically extracted from audio recordings and transcripts could be used to distinguish between epileptic seizures and PNES and thereby contribute to the differential diagnosis of TLOC. Future research should explore whether additional observations can be incorporated into a diagnostic stratification tool. Moreover, future research should explore the performance of these features when they have been extracted from transcripts produced by automatic speech recognition and when they are combined with additional information provided by patients and witnesses about seizure manifestations and medical history.

scholarly journals Value of tongue biting in the differential diagnosis between epileptic seizures and syncope

Seizure ◽  
2012 ◽  
Vol 21 (8) ◽  
pp. 568-572 ◽  
Author(s):  
Francesco Brigo ◽  
Raffaele Nardone ◽  
Luigi Giuseppe Bongiovanni
Keyword(s):  
Differential Diagnosis ◽  
Epileptic Seizures

An update on non-epileptic seizures: Diagnosis and brief notes on treatment

2013 ◽  
Vol 4 (2) ◽  
Author(s):  
Bernt Engelsen ◽  
Arne Gramstad ◽  
Atle Lillebø ◽  
Bjørn Karlsen
Keyword(s):  
Differential Diagnosis ◽  
Sleep Disturbances ◽  
Treatment Options ◽  
Epileptic Seizures ◽  
Diagnostic Procedures ◽  
University Hospital ◽  
Team Approach ◽  
Motor Symptoms ◽  
Recommended Treatment ◽  
Appropriate Treatment

AbstractNon-epileptic seizures (NES) are episodes that appear as epileptic seizures, but are not caused by epileptic discharges in the brain. The inclusion of NES in the differential diagnosis of epileptic seizures is important, as an accurate diagnosis is required for the administration of appropriate treatment. NES in the differential diagnosis may be classified as (1) physiologic or pathophysiologic NES, e.g. syncope, sleep disturbances, motor symptoms, migraine attacks, etc., and (2) psychogenic NES (PNES), e.g. affective disorders with anxiety or panic, dissociative disorders (somatoform or conversion) as well as depression or posttraumatic stress disorder (PTSD). PNES is the condition most frequently misdiagnosed as epilepsy. We report NES as experienced in our epilepsy monitoring unit (EMU) for adults in the neurology department of a university hospital in Norway. Our main emphasis is on PNES, highlighting the diagnostic procedures, currently recommended treatment options, and follow-up. A team approach with video-EEG monitoring and clinical observation by trained nurses, epileptologists and other personnel is preferred in the diagnosis and treatment of PNES. Evaluations are performed by a neuropsychologist and trained social worker. The EMU closely cooperates with cardiologists and sleep center specialists. They can also refer patients to psychosomatic medicine specialists. Components of the differential diagnosis addressed are syncope, motor symptoms, sleep disorders, migraine and other paroxysmal neurological symptoms.

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