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Chapter 9 - Nonepileptic Spells

Published online by Cambridge University Press:  11 October 2019

Vibhangini S. Wasade
Henry Ford Medical Group HFHS, Michigan
Marianna V. Spanaki
Wayne State University, Michigan
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Seizures and epilepsy are frequently misdiagnosed. Only about 50% of patients transferred to ICUs in tertiary hospitals after presumed status epilepticus are found to have status epilepticus.1 About 90% of those misdiagnosed with epilepsy actually have psychogenic nonepileptic event (PNEE).2 There are many other disorders misdiagnosed as epilepsy, organic and nonorganic, seen in adults and children. This chapter discusses the common differential diagnoses for epilepsy in hopes of making recognition of epilepsy imitators easier. As with any disorder, misdiagnosis delays the appropriate treatment needed to provide relief to the patient. In PNEE, a completely different therapeutic approach is needed (versus epileptic seizures), including psychotherapy and psychotropic medications. Antiseizure drugs (ASDs) used in those who do not need them place an unnecessary risk of common and rare side effects.

Understanding Epilepsy
A Study Guide for the Boards
, pp. 176 - 188
Publisher: Cambridge University Press
Print publication year: 2019

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