Tuesday, 11 February 2014

How To Differentiate Psychological Seizures From Epileptic Ones

Psychological seizures or non-epileptic attack disorders are very similar to epileptic seizures, therefore they are often misdiagnosed and treated with the wrong drugs. There are estimations that show 20% of seizure patients diagnosed with epilepsy don't respond to the treatment given to them by their doctors, the reason being that they don't suffer from epilepsy in the first place.

There are some physical clues which can help specialist tell psychological seizures from epilepsy ones, but sometimes these clues can be misleading. One of the most relevant is the eye movements during the seizure. A study done by the Barrow Neurological Institute in Phoenix, Arizona revealed that almost all patients who had a non-epileptic seizure had their eyes closed during the event, while almost all those who suffered epileptic seizures either had their eyes opened or blinked during the whole time. These findings are interesting, but they still need to be confirmed. Being able to differentiate early between the two types of seizures is very important, as it could prevent many failed treatments caused by the fact that patients receive drugs for a condition they don't actually suffer from.

The main difference between psychological seizures and epileptic ones is the absence of the electrical discharges in the brain that are characteristic for epilepsy sufferers. The differential diagnosis starts by ruling out epilepsy, migraine, stroke, vertigo or syncope as possible causes of the seizures.

The best method to rule out epilepsy is to record the electrical signals in the brain. This is done with a video-electroencephalogram, also known as EEG. Sensors are place don the patient's scalp, then their EEG is recorded while they are also videotaped. This test is usually done over a period of several days, in order to allow time for the seizures to occur. It is important that the patient is also recorded on video, because the EEG test can give lots of false positives in both the general population and in patients suffering from other psychiatric disorders that are characterized by seizures similar to psychological ones such as panic disorders or schizophrenia.

Although highly relevant, many times this test is skipped by neurologists, who directly put their patients on epilepsy drugs. If a patient doesn't respond to a certain drug, the specialists then tries different drugs, but none of them is successful in the end, since the patient doesn't suffer from epilepsy.

No comments:

Post a Comment