Rethinking Seizure Care Blog

Cutting Down on Misdiagnosis of Epileptic Patients

Posted by RSC Diagnostics on Jan 15, 2021

Doctor and surgeon visiting female patient in the hospital

Anyone who experiences a seizure or seizure-like episode will naturally be frightened, especially if it is the first time it has happened. It is especially frightening to watch an episode occur in a child and stand by feeling helpless. With misdiagnoses of epilepsy running around 30%, it is vital to reduce this number as much as possible so patients receive proper diagnoses and treatments.

Conditions Often Misdiagnosed as Epilepsy

Just because someone has a seizure, it does not necessarily mean that he or she is epileptic. A number of other things can cause seizures. A patient may be positively or negatively misdiagnosed with epilepsy. Sometimes, a misdiagnosis will cause a patient to believe that he or she is not epileptic when they actually do suffer from epilepsy. Other times, conditions are misdiagnosed as epilepsy when they are something else entirely. There are several conditions that commonly get misdiagnosed as epilepsy.

Febrile seizures are those that occur as the result of high fevers. Young children and infants are often the ones who suffer from these types of seizures. They are surprisingly common, affecting around 1 out of every 25 children. Children will usually outgrow these types of seizures.

Non-epileptic seizure disorder, or NESD, look like seizures, but they are not. Some of the conditions that can cause non-epileptic events include sleep disorders such as narcolepsy, Tourette's syndrome, and cardiac arrhythmia.

In some cases, epilepsy has actually been misdiagnosed as schizophrenia. Some seizures cause patients to suffer hallucinations and/or psychotic symptoms. This may lead some doctors to believe it is schizophrenia when it is actually an epileptic disorder.

Misdiagnoses are always dangerous because it means the patient is not getting the help that he or she truly needs. Doctors always need to look at the condition from every possible angle to come to the correct diagnosis. The data collected from a traditional, in-hospital EEG may not be as helpful as many believe.

Improved EEGs Necessary

In most cases, a traditional EEG is provided in the hospital setting and involves a test that is less than an hour long. While this might give a cursory look into the electrical activity that's going on inside of the patient’s brain, it is a very tiny slice of what is really happening. What is missing is all the other brain activity that is happening during the remaining 23 hours of the day. It’s just not enough data to make a conclusive diagnosis. In contrast, an ambulatory EEG (often conducted in the patient’s home) provides doctors with a much better look at what is actually happening in the patient's brain.

Fortunately, there are new EEG testing options available that provide doctors with greater diagnostic yield for more accurate diagnoses. An outpatient AEEG with video can allow for more accurate diagnoses and lower the risk of misdiagnosis. It's better for the patients and the doctors alike, as they are able to get more information and more accurate information about the electrical impulses in the patient's brain. Ambulatory EEGs run from one to five days (and are typically performed in the patient’s home). This longer testing increases the “diagnostic yield” so doctors can more accurately diagnose and provide proper treatment. After all, how much can really be learned about a person's overall health in a 20 to 40-minute session with a traditional EEG? These exciting new technological advances are helping to gain better insight and reduce misdiagnoses of epilepsy.

 

Resources:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2065943/

http://epilepsytalk.com/2010/02/17/conditions-commonly-misdiagnosed-as-epilepsy/

http://www.cbsnews.com/news/seizures-often-misdiagnosed-as-epilepsy-actually-stress-study/

 

Topics: In-Home Video EEG