The differential diagnosis of epilepsy: A critical review

The wrong diagnosis of epilepsy is common. At referral epilepsy centers, psychogenic non-epileptic attacks are by far the most common Condition found to have been misdiagnosed as epilepsy, with all average delay of 7-10 years. There are many "red flags" that call raise the Suspicion of psychogenic non-epileptic attacks. Syncope is the second most common condition misdiagnosed as epilepsy, and it is probably more common in outpatient populations. Other conditions more rarely misdiagnosed as epilepsy include hypoglycemia, panic attacks, paroxysmal movement disorders, paroxysmal steel disorders, TIAs, migraines, and TGA. Conditions specific to children include nonepileptic staring spells, breath-holding spells, and shudder attacks. At all ages, the over-interpretation of EEGs plays in important part ill the misdiagnosis of epilepsy. (C) 2009 Elsevier Inc. All rights reserved.