Abstract
The diagnosis of epilepsy rests on a detailed history and examination. The main focus of such a history is to exclude the possibility of non-epileptic paroxysmal events. An incorrect diagnosis of epilepsy can potentially lead to physical, psychological and financial harm to the child and the family. A wide range of non-epileptic paroxysmal events can occur in children. The differentiation of a seizure mimic from a seizure relies solely on a proper history and review of video recordings. Investigations rarely help in the diagnosis of these events. An early and timely diagnosis and proper parental counseling helps avoiding unnecessary investigations, treatment and allays parental anxiety. The article reviews the common non-epileptic paroxysmal events in children, emphasizing clinically relevant points.
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References
Apakama O, Appleton R. Non-epileptic clinical diagnoses in children referred for an outpatient EEG using video monitoring. Epileptic Disord. 2006;8:156–8.
Uldall P, Alving J, Hansen LK, Kibæk M, Buchholt J. The misdiagnosis of epilepsy in children admitted to a tertiary epilepsy centre with paroxysmal events. Arch Dis Child. 2006;91:219–21.
Wallace SJ, Farell K. Epilepsy in Childhood. 2nd ed. New Delhi: JAYPEE Brothers Medical Publishers(P) Ltd; 2006.
Stephenson JB. Anoxic seizures: self-terminating syncopes. Epileptic Disord. 2001;3:3–6.
Iyer A, Appleton R. Management of reflex anoxic seizures in children. Arch Dis Child. 2013;98:714–7.
Reuber M. Psychogenic nonepileptic seizures: diagnosis, aetiology, treatment and prognosis. Schweiz Arch Neurol Psychiatr 2005;156:47–57.
Mahowald MW. Parasomnias. Med Clin North Am. 2004;88:669–78.
Dyken ME, Lin-Dyken DC, Yamada T. Diagnosing rhythmic movement disorder with video-polysomnography. Pediatr Neurol. 1997;16:37–41.
Derry CP. Sleeping in fits and starts: a practical guide to distinguishing nocturnal epilepsy from sleep disorders. Pract Neurol. 2014 Jun 9. pii: practneurol-2014-000890. doi:10.1136/practneurol-2014-000890. [Epub ahead of print].
Vendrame M, Kothare SV. Epileptic and nonepileptic paroxysmal events out of sleep in children. J Clin Neurophysiol. 2011;28:111–9.
Mackay M. Fits, faints and funny turns in children. Aust Fam Physician. 2005;34:1003–8.
Tandon PN, Bajpai PC. The infantile tremor syndrome. In: Spillane JD, editor. Tropical neurology. London: Oxford University Press; 1973. p. 114–9.
Garewal G, Narang A, Das KC. Infantile tremor syndrome: a vitamin B12 deficiency syndrome in infants. J Trop Pediatr. 1988;34:174–8.
Nechay A, Ross LM, Stephenson JBP, Regan MO. Gratification disorder (“infantile masturbation”): a review. Arch Dis Child. 2004;89:225–6.
Ramdhani NA, Sikma MA, Witkamp TD, Slooter AJ, de Lange DW. Paroxysmal autonomic instability with dystonia in a patient with tuberculous meningitis: a case report. J Med Case Rep. 2010;4:304.
Kapoor D, Singla D, Singh J, Jindal R. Paroxysmal autonomic instability with dystonia (PAID) syndrome following cardiac arrest. Singapore Med J. 2013 Dec 31. doi:10.11622/smedj.2013264.
Blackman JA, Patrick PD, Buck ML, Rust Jr RS. Paroxysmal autonomic instability with dystonia after brain injury. Arch Neurol. 2004;61:321–8.
Barry S, Baird G, Lascelles K, Bunton P, Hedderly T. Neurodevelopmental movement disorders — an update on childhood motor stereotypies. Dev Med Child Neurol. 2011;53:979–85.
Finkelhor BK, Harker LA. Benign paroxysmal vertigo of childhood. Laryngoscope. 1987;97:1161–3.
Sanger TD, Chen D, Fehlings DL, Hallett M, Lang AE, Mink JW, et al. Definition and classification of hyperkinetic movements in childhood. Mov Disord. 2010;25:1538–49.
Coulter DL, Allen RJ. Benign neonatal sleep myoclonus. Arch Neurol. 1982;39:191–2.
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Sankhyan, N. Non-epileptic Paroxysmal Events Mimicking Seizures. Indian J Pediatr 81, 898–902 (2014). https://doi.org/10.1007/s12098-014-1531-3
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DOI: https://doi.org/10.1007/s12098-014-1531-3