Advertisement

Common Childhood Epilepsy Mimics

Chapter
  • 546 Downloads

Abstract

Unusual movements in children frequently generate concern of underlying seizures from parents and lead to professional review. Stigma associated with epilepsy heightens anxiety and a wish to confirm or exclude the diagnosis as soon as possible. These considerations could lead to a wrong diagnosis of epilepsy being given with unwarranted exposure to medications with potential side effects and cost burden to families.

This chapter seeks to provide practitioners in pediatric epilepsy with an exploration of practical differential diagnoses for epilepsy in children, particularly for convulsive seizures. Evaluation of all epilepsy mimics requires a precise and relevant history to help arrive at a diagnosis. Epilepsy mimics across various ages will be reviewed, with the most common differential diagnoses presented first.

Examples of common potential epilepsy mimics include benign sleep myoclonus, which is frequently observed in infants and may be a challenge to differentiate from myoclonic seizures in infants. It is a very common phenomenon in pre-term infants with an incidence of 57–132 per 1000 live births. Breath-holding spells among toddlers are common and may be mistaken for epilepsy, as can reflex anoxic seizures. Self-gratification phenomena have been observed from infancy onward and may resemble clonic seizures.

Inattention in school-going children is a differential diagnosis for absence seizures and both conditions may co-exist. Stressed or traumatized children may present with non-epileptic psychogenic seizures, as can children with established seizures. Lack of concurrent electrophysiological correlates and absence of stereotypic presentation help differentiate inattention and non-epileptic seizures from childhood epilepsy. Sleep-related activity such as hallucinations, parasomnias, and hypnagogic jerks could also be mistaken for epilepsy in children. Video electroencephalogram (video-EEG) telemetry evaluation is invaluable in such cases. Lack of video-EEG services, simple videos, or EEG studies in resource-poor settings makes diagnosis of epilepsy imitators challenging. The differences between epilepsy and common differential diagnoses for practitioners in resource-limited settings who may lack access to requisite investigative tools will be addressed in the following text.

The outcome for most epilepsy mimics is excellent with minimal morbidity and mortality. The potential danger posed by unnecessary medical interventions caused by misdiagnosis of epilepsy makes it imperative that this possibility is minimized.

References

  1. 1.
    Goraya JS, Singla G, Mahey H. Benign neonatal sleep myoclonus: frequently misdiagnosed as neonatal seizures. Indian Pediatr. 2015;52(8):713–4.PubMedGoogle Scholar
  2. 2.
    Sharma D, Murki S, Pratap OT. Benign sleep myoclonus in neonate: a diagnostic dilemma for neonatologist. BMJ Case Rep. 2014;  https://doi.org/10.1136/bcr-2014-206626; pii: bcr2014206626.
  3. 3.
    Chen L, Knight EM, Tuxhorn I, Shahid A, Lüders HO. Paroxysmal non-epileptic events in infants and toddlers: a phenomenologic analysis. Psychiatry Clin Neurosci. 2015;69(6):351–9.  https://doi.org/10.1111/pcn.12245; Epub 2014 Dec 1.CrossRefPubMedGoogle Scholar
  4. 4.
    Tinuper P, Bisulli F, Cross JH, Hesdorffer D, Kahane P, Nobili L, Provini F, Scheffer IE, Tassi L, Vignatelli L, Bassetti C, Cirignotta F, Derry C, Gambardella A, Guerrini R, Halasz P, Licchetta L, Mahowald M, Manni R, Marini C, Mostacci B, Naldi I, Parrino L, Picard F, Pugliatti M, Ryvlin P, Vigevano F, Zucconi M, Berkovic S, Ottman R. Definition and diagnostic criteria of sleep-related hypermotor epilepsy. Neurology. 2016;86(19):1834–42.  https://doi.org/10.1212/WNL.0000000000002666; Epub 2016 Apr 15.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Gurkas E, Serdaroglu A, Hirfanoglu T, Kartal A, Yılmaz U, Bilir E. Sleep-wake distribution and circadian patterns of epileptic seizures in children. Eur J Paediatr Neurol. 2016;4:549–54.  https://doi.org/10.1016/j.ejpn.2016.04.004; Epub 2016 Apr 13.CrossRefGoogle Scholar
  6. 6.
    Serino D, Fusco L. Epileptic hypnagogic jerks mimicking repetitive sleep starts. Sleep Med. 2015;8:1014–6.  https://doi.org/10.1016/j.sleep.2015.04.015; Epub 2015 May 27.CrossRefGoogle Scholar
  7. 7.
    Walters AS. Clinical identification of the simple sleep-related movement disorders. Chest. 2007;131(4):1260–6.PubMedGoogle Scholar
  8. 8.
    Fusco L, Pachatz C, Cusmai R, Vigevano F. Repetitive sleep starts in neurologically impaired children: an unusual non-epileptic manifestation in otherwise epileptic subjects. Epileptic Disord. 1999;1:63–7.PubMedGoogle Scholar
  9. 9.
    Ohayon MM, Caulet M, Priest RG. Violent behavior during sleep. J Clin Psychiatry. 1997;58(8):369–76; quiz 377.PubMedGoogle Scholar
  10. 10.
    Wichniak A, Tracik F, Geisler P, et al. Rhythmic feet movements while falling asleep. Mov Disord. 2001;16:1164.PubMedGoogle Scholar
  11. 11.
    American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.Google Scholar
  12. 12.
    Bassetti C, Vella S, Donati F, et al. SPECT during sleepwalking. Lancet. 2000;356:484.PubMedGoogle Scholar
  13. 13.
    Oliviero A, Della Marca G, Tonali PA, et al. Functional involvement of cerebral cortex in adult sleepwalking. J Neurol. 2007;254:1066.PubMedGoogle Scholar
  14. 14.
    Horváth A, Papp A, Szűcs A. Progress in elucidating the pathophysiological basis of nonrapid eye movement parasomnias: not yet informing therapeutic strategies. Nat Sci Sleep. 2016;8:73–9.  https://doi.org/10.2147/NSS.S71513; eCollection 2016.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    St Louis EK, Cascino GD. Diagnosis of epilepsy and related episodic disorders. Continuum (Minneap Minn). 2016;(1 Epilepsy):15–37.  https://doi.org/10.1212/CON.0000000000000284.
  16. 16.
    Sinha S, Jhaveri R, Banga A. Sleep disturbances and behavioral disturbances in children and adolescents. Psychiatr Clin North Am. 2015;38(4):705–21.  https://doi.org/10.1016/j.psc.2015.07.009; Epub 2015 Aug 31.CrossRefPubMedGoogle Scholar
  17. 17.
    Moreno MA. Sleep terrors and sleepwalking: common Parasomnias of childhood. JAMA Pediatr. 2015;169(7):704.  https://doi.org/10.1001/jamapediatrics.2014.2140.CrossRefPubMedGoogle Scholar
  18. 18.
    Miano S, Esposito M, Foderaro G, Ramelli GP, Pezzoli V, Manconi M. Sleep-related disorders in children with attention-deficit hyperactivity disorder: preliminary results of a full sleep assessment study. CNS Neurosci Ther. 2016;  https://doi.org/10.1111/cns.12573; [Epub ahead of print].
  19. 19.
    Scammell TE. Narcolepsy. N Engl J Med. 2015;373(27):2654–62.  https://doi.org/10.1056/NEJMra1500587.CrossRefPubMedGoogle Scholar
  20. 20.
    Rocca FL, Pizza F, Ricci E, Plazzi G. Narcolepsy during childhood: an update. Neuropediatrics. 2015;46(3):181–98.  https://doi.org/10.1055/s-0035-1550152; Epub 2015 May 11.CrossRefPubMedGoogle Scholar
  21. 21.
    Meletti S, Vaudano AE, Pizza F, Ruggieri A, Vandi S, Teggi A, Franceschini C, Benuzzi F, Nichelli PF, Plazzi G. The brain correlates of laugh and cataplexy in childhood narcolepsy. J Neurosci. 2015;35(33):11583–94.  https://doi.org/10.1523/JNEUROSCI.0840-15.2015.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Santos Nde O, Benute GR, Santiago A, Marchiori PE, Lucia MC. Psychogenic non-epileptic seizures and psychoanalytical treatment: results. Rev Assoc Med Bras. 2014;60(6):577–84.  https://doi.org/10.1590/1806-9282.60.06.018.CrossRefPubMedGoogle Scholar
  23. 23.
    Yi YY, Kim HD, Lee JS, Cheon KA, Kang HC. Psychological problems and clinical outcomes of children with psychogenic non-epileptic seizures. Yonsei Med J. 2014;55(6):1556–61.  https://doi.org/10.3349/ymj.2014.55.6.1556.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Dhiman V, Sinha S, Rawat VS, Vijaysagar KJ, Thippeswamy H, Srinath S, Chaturvedi SK, Satishchandra P. Children with psychogenic non-epileptic seizures (PNES): a detailed semiologic analysis and modified new classification. Brain and Development. 2014;36(4):287–93.  https://doi.org/10.1016/j.braindev.2013.05.002; Epub 2013 Jun 10.CrossRefPubMedGoogle Scholar
  25. 25.
    Plioplys S, Doss J, Siddarth P, Bursch B, Falcone T, Forgey M, Hinman K, LaFrance WC Jr, Laptook R, Shaw RJ, Weisbrot DM, Willis MD, Caplan R. Risk factors for comorbid psychopathology in youth with psychogenic non-epileptic seizures. Seizure. 2016;38:32–7.  https://doi.org/10.1016/j.seizure.2016.03.012; Epub 2016 Apr 2.CrossRefPubMedGoogle Scholar
  26. 26.
    Sawchuk T, Buchhalter J. Psychogenic non-epileptic seizures in children – psychological presentation, treatment, and short-term outcomes. Epilepsy Behav. 2015;52(Pt A):49–56.  https://doi.org/10.1016/j.yebeh.2015.08.032; Epub 2015 Sep 24.CrossRefPubMedGoogle Scholar
  27. 27.
    Rawat VS, Dhiman V, Sinha S, Vijay Sagar KJ, Thippeswamy H, Chaturvedi SK, Srinath S, Satishchandra P. Co-morbidities and outcome of childhood psychogenic non-epileptic seizures-an observational study. Seizure. 2015;25:95–8.  https://doi.org/10.1016/j.seizure.2014.09.011; Epub 2014 Oct 5.CrossRefPubMedGoogle Scholar
  28. 28.
    Alper K, Devinsky O, Perrine K, et al. Nonepileptic seizures and childhood sexual and physical abuse. Neurology. 1993;43:1950.PubMedGoogle Scholar
  29. 29.
    Lancman ME, Brotherton TA, Asconapé JJ, Penry JK. Psychogenic seizures in adults: a longitudinal analysis. Seizure. 1993;2:281.PubMedGoogle Scholar
  30. 30.
    Scheepers B, Budd S, Curry S, et al. Non-epileptic attack disorder: a clinical audit. Seizure. 1994;3:129.PubMedGoogle Scholar
  31. 31.
    Duncan R, Oto M. Predictors of antecedent factors in psychogenic nonepileptic attacks: multivariate analysis. Neurology. 2008;71:1000.PubMedGoogle Scholar
  32. 32.
    Rajapakse T, Buchhalter J. The borderland of migraine and epilepsy in children. Headache. 2016;  https://doi.org/10.1111/head.12827; [Epub ahead of print].
  33. 33.
    Salanova V, Andermann F, Olivier A, et al. Occipital lobe epilepsy: electroclinical manifestations, electrocorticography, cortical stimulation and outcome in 42 patients treated between 1930 and 1991. Surgery of occipital lobe epilepsy. Brain. 1992;115(Pt 6):1655.PubMedGoogle Scholar
  34. 34.
    Blume WT, Whiting SE, Girvin JP. Epilepsy surgery in the posterior cortex. Ann Neurol. 1991;29:638.PubMedGoogle Scholar
  35. 35.
    Aykut-Bingol C, Bronen RA, Kim JH, et al. Surgical outcome in occipital lobe epilepsy: implications for pathophysiology. Ann Neurol. 1998;44:60.PubMedGoogle Scholar
  36. 36.
    Pelzer N, Blom DE, Stam AH, Vijfhuizen LS, Hageman A, van Vliet JA, Ferrari MD, van den Maagdenberg A, Haan J, Terwindt GM. Recurrent coma and fever in familial hemiplegic migraine type 2. A prospective 15-year follow-up of a large family with a novel ATP1A2 mutation. Cephalalgia. 2016; pii: 0333102416651284; [Epub ahead of print].Google Scholar
  37. 37.
    Russell MB, Ducros A. Sporadic and familial hemiplegic migraine: pathophysiological mechanisms, clinical characteristics, diagnosis, and management. Lancet Neurol. 2011;10:457.PubMedGoogle Scholar
  38. 38.
    Thomsen LL, Kirchmann M, Bjornsson A, et al. The genetic spectrum of a population-based sample of familial hemiplegic migraine. Brain. 2007;130:346.PubMedGoogle Scholar
  39. 39.
    Giffin NJ, Benton S, Goadsby PJ. Benign paroxysmal torticollis of infancy: four new cases and linkage to CACNA1A mutation. Dev Med Child Neurol. 2002;44:490.PubMedGoogle Scholar
  40. 40.
    Shin M, Douglass LM, Milunsky JM, Rosman NP. The genetics of benign paroxysmal torticollis of infancy: is there an association with mutations in the CACNA1A gene? J Child Neurol. 2016; pii: 0883073816636226; [Epub ahead of print].Google Scholar
  41. 41.
    Tumturk A, Kaya Ozcora G, Kacar Bayram A, Kabaklioglu M, Doganay S, Canpolat M, Gumus H, Kumandas S, Unal E, Kurtsoy A, Per H. Torticollis in children: an alert symptom not to be turned away. Childs Nerv Syst. 2015;31(9):1461–70.  https://doi.org/10.1007/s00381-015-2764-9; Epub 2015 Jun 5.CrossRefPubMedGoogle Scholar
  42. 42.
    Casani AP, Dallan I, Navari E, Sellari Franceschini S, Cerchiai N. Vertigo in childhood: proposal for a diagnostic algorithm based upon clinical experience. Acta Otorhinolaryngol Ital. 2015;35(3):180–5.PubMedPubMedCentralGoogle Scholar
  43. 43.
    Taylor I, Berkovic SF, Kivity S, Scheffer IE. Benign occipital epilepsies of childhood: clinical features and genetics. Brain. 2008;131:2287.PubMedGoogle Scholar
  44. 44.
    Covanis A. Panayiotopoulos syndrome: a benign childhood autonomic epilepsy frequently imitating encephalitis, syncope, migraine, sleep disorder, or gastroenteritis. Pediatrics. 2006;118:e1237.PubMedGoogle Scholar
  45. 45.
    Brahmbhatt K, Hilty DM, Hah M, Han J, Angkustsiri K, Schweitzer J. Diagnosis and treatment of attention deficit hyperactivity disorder during adolescence in the primary care setting: a concise review. J Adolesc Health. 2016;  https://doi.org/10.1016/j.jadohealth.2016.03.025; pii: S1054-139X(16)00104-X; [Epub ahead of print] Review.
  46. 46.
    Singh A, Yeh CJ, Verma N, Das AK. Overview of attention deficit hyperactivity disorder in young children. Health Psychol Res 2015;3(2):2115. doi:  https://doi.org/10.4081/hpr.2015.2115. eCollection 2015 Sep 30. Review.
  47. 47.
    Ruggieri VL, Arberas CL. Non-epileptic motor paroxysmal phenomena in wakefulness in childhood. Rev Neurol. 2013;57(Suppl 1):S105–14. [Article in Spanish]PubMedGoogle Scholar
  48. 48.
    Iyer A, Appleton R. Management of reflex anoxic seizures in children. Arch Dis Child. 2013;98(9):714–7.  https://doi.org/10.1136/archdischild-2012-303133; Epub 2013 Jun 28.CrossRefPubMedGoogle Scholar
  49. 49.
    Kanjwal K, Calkins H. Syncope in children and adolescents. Cardiol Clin. 2015;33(3):397–409.  https://doi.org/10.1016/j.ccl.2015.04.008. ReviewCrossRefPubMedGoogle Scholar
  50. 50.
    Vallone R, Placidi S, Pennacchia M, Gentile S, Drago FG. Psychological profile of children with neurogenic syncope. Ital Cardiol (Rome). 2014;15(10):531–4.  https://doi.org/10.1714/1672.18302; [Article in Italian].CrossRefGoogle Scholar
  51. 51.
    Johnsrude CL. Current approach to pediatric syncope. Pediatr Cardiol. 2000;21:522–31.PubMedGoogle Scholar
  52. 52.
    Benditt DG, van Dijk JG, Sutton R, Wieling W, Lin JC, Sakaguchi S, et al. Syncope. Curr Probl Cardiol. 2004;29:152–229.PubMedGoogle Scholar
  53. 53.
    Shim SH, Park SY, Moon SN, Oh JH, Lee JY, Kim HH, Han JW, Lee SJ. Baseline heart rate variability in children and adolescents with vasovagal syncope. Korean J Pediatr. 2014;57(4):193–8.  https://doi.org/10.3345/kjp.2014.57.4.193.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Garg AK, Paul SP. Reflex anoxic seizures are not epileptic fits: a management dilemma. Indian J Pediatr. 2013;80(7):531–3.  https://doi.org/10.1007/s12098-012-0953-z; Epub 2012 Dec 28.CrossRefPubMedGoogle Scholar
  55. 55.
    Horrocks IA, Nechay A, Stephenson JB, Zuberi SM. Anoxic-epileptic seizures: observational study of epileptic seizures induced by syncopes. Arch Dis Child. 2005;90(12):1283–7; Epub 2005 Sep 13.PubMedPubMedCentralGoogle Scholar
  56. 56.
    Luat AF, Kamat D, Sivaswamy L. Paroxysmal nonepileptic events in infancy, childhood, and adolescence. Pediatr Ann. 2015;44(2):e18–23.  https://doi.org/10.3928/00904481-20150203-07; Review.CrossRefPubMedGoogle Scholar
  57. 57.
    Perlmuter LC, Sarda G, Casavant V, Mosnaim AD. A review of the etiology, associated comorbidities, and treatment of orthostatic hypotension. Am J Ther. 2013;20(3):279–91.  https://doi.org/10.1097/MJT.0b013e31828bfb7f; Review.CrossRefPubMedGoogle Scholar
  58. 58.
    Stewart JM. Common syndromes of orthostatic intolerance. Pediatrics. 2013;131(5):968–80.  https://doi.org/10.1542/peds.2012-2610; Epub 2013 Apr 8.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Aicardi J, Gastatut H, Mises J. Syncopal attacks compulsively self-induced by Valsalva’s maneuver associated with typical absence seizures. A case report. Arch Neurol. 1988;45:923–5.PubMedGoogle Scholar
  60. 60.
    Waddell-Smith KE, Skinner JR, members of the CSANZ Genetics Council Writing Group. Update on the diagnosis and management of familial long QT syndrome. Heart Lung Circ. 2016;  https://doi.org/10.1016/j.hlc.2016.01.020; [Epub ahead of print]; pii: S1443-9506(16)30003-8.
  61. 61.
    Movahedian AH, Heidarzadeh Arani M, Motaharizad D, Mousavi GA, Mosayebi Z. Evaluation of QT dispersion in children with breath holding spells. Iran J Child Neurol. 2016;10(1):25–30.PubMedPubMedCentralGoogle Scholar
  62. 62.
    Kothari SS. Mechanism of cyanotic spells in tetralogy of Fallot – the missing link? Int J Cardiol. 1992;37:1.PubMedGoogle Scholar
  63. 63.
    Silva RR, Munoz DM, Barickman J, Friedhoff AJ. Environmental factors and related fluctuation of symptoms in children and adolescents with Tourette’s disorder. J Child Psychol Psychiatry. 1995;36(2):305–12.  https://doi.org/10.1111/j.1469-7610.1995.tb01826.x.CrossRefPubMedGoogle Scholar
  64. 64.
    Albanese A, Jankovic J. Distinguishing clinical features of hyperkinetic disorders. In: Albanese A, Jankovic J, editors. Hyperkinetic movement disorders. Oxford: Wiley-Blackwell; 2012. p. 3.Google Scholar
  65. 65.
    Sanger TD, Chen D, Fehlings DL, et al. Definition and classification of hyperkinetic movements in childhood. Mov Disord. 2010;25:1538.PubMedPubMedCentralGoogle Scholar
  66. 66.
    Manca D, Liyanaarachchi R, Starreveld E. Diagnosis and treatment of paroxysmal kinesigenic dyskinesia in a 15-year-old boy. Can Family Med. 2014;60:445–7.Google Scholar
  67. 67.
    Walker M, Kullmann D, Warner T, Jarman P, Hanna M, Kurian MA, Bhatia KP, Houlden H, Gardiner AR, Jaffer F, Dale RC, Labrum R, Erro R, Meyer E, Xiromerisiou G, Stamelou M. The clinical and genetic heterogeneity of paroxysmal dyskinesias. Brain. 2015;138(Pt 12):3567–80.  https://doi.org/10.1093/brain/awv310; Epub 2015 Nov 23. Review.CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Huang XJ, Wang T, Wang JL, Liu XL, Che XQ, Li J, Mao X, Zhang M, Bi GH, Wu L, Zhang Y, Wang JY, Shen JY, Tang BS, Cao L, Chen SD. Paroxysmal kinesigenic dyskinesia: clinical and genetic analyses of 110 patients. Neurology. 2015;85(18):1546–53.PubMedGoogle Scholar
  69. 69.
    Mink JW. Treatment of paroxysmal dyskinesias in children. Curr Treat Options Neurol. 2015;17(6):350.  https://doi.org/10.1007/s11940-015-0350-9.CrossRefPubMedGoogle Scholar
  70. 70.
    Kumar A, Szekely A, Jabbari B. Effective treatment of paroxysmal nonkinesigenic dyskinesia with oxcarbazepine. Clin Neuropharmacol. 2016;39(4):201–5.PubMedGoogle Scholar
  71. 71.
    Peila E, Mortara P, Cicerale A, Pinessi L. Paroxysmal non-kinesigenic dyskinesia, post-streptococcal syndromes and psychogenic movement disorders: a diagnostic challenge. BMJ Case Rep. 2015;2015  https://doi.org/10.1136/bcr-2014-207449; pii: bcr2014207449.
  72. 72.
    Ozbay OE. Idiopathic paroxysmal tonic upward gaze. Pediatr Neurol. 2012;47(4):306–8.  https://doi.org/10.1016/j.pediatrneurol.2012.05.028.CrossRefPubMedGoogle Scholar
  73. 73.
    Blumkin L, Leshinsky-Silver E, Michelson M, Zerem A, Kivity S, Lev D, Lerman-Sagie T. Paroxysmal tonic upward gaze as a presentation of de-novo mutations in CACNA1A. Eur J Paediatr Neurol. 2015;3:292–7.  https://doi.org/10.1016/j.ejpn.2014.12.018; Epub 2015 Jan 8.CrossRefGoogle Scholar
  74. 74.
    Ouvrier RA, Billson F. Benign paroxysmal tonic upgaze of childhood. J Child Neurol. 1988;3(3):177–80.PubMedGoogle Scholar
  75. 75.
    Jen JC, Graves TD, Hess EJ, et al. Primary episodic ataxias: diagnosis, pathogenesis and treatment. Brain. 2007;130:2484.PubMedGoogle Scholar
  76. 76.
    Tomlinson SE, Rajakulendran S, Tan SV, et al. Clinical, genetic, neurophysiological and functional study of new mutations in episodic ataxia type 1. J Neurol Neurosurg Psychiatry. 2013;84:1107.PubMedPubMedCentralGoogle Scholar
  77. 77.
    Graves TD, Cha YH, Hahn AF, et al. Episodic ataxia type 1: clinical characterization, quality of life and genotype-phenotype correlation. Brain. 2014;137:1009.PubMedPubMedCentralGoogle Scholar
  78. 78.
    Jen J, Kim GW, Baloh RW. Clinical spectrum of episodic ataxia type 2. Neurology. 2004;62:17.PubMedGoogle Scholar
  79. 79.
    Guterman EL, Yurgionas B, Nelson AB. Pearls & Oysters: episodic ataxia type 2: case report and review of the literature. Neurology. 2016;86(23):e239–41.  https://doi.org/10.1212/WNL.0000000000002743.CrossRefPubMedPubMedCentralGoogle Scholar
  80. 80.
    Sweney MT, Silver K, Gerard-Blanluet M, et al. Alternating hemiplegia of childhood: early characteristics and evolution of a neurodevelopmental syndrome. Pediatrics. 2009;123:e534.PubMedGoogle Scholar
  81. 81.
    Yang X, Zhang Y, Yuan D, Xu X, Li S, Wei L, Wu Y, Xiong H, Liu X, Bao X, Jiang Y, Wu X. ATP1A3 gene mutations in patients with alternating hemiplegia of childhood. Zhonghua Er Ke Za Zhi. 2015;53(11):835–9; [Article in Chinese].PubMedGoogle Scholar
  82. 82.
    Andrew M, Owen MJ. Hyperekplexia: abnormal startle response due to glycine receptor mutations. Br J Psychiatry. 1997;170:106.PubMedGoogle Scholar
  83. 83.
    Zhang Y, Bode A, Nguyen B, Keramidas A, Lynch JW. Investigating the mechanism by which gain-of-function mutations to the α1 glycine receptor cause hyperekplexia. J Biol Chem. 2016; pii: jbc.M116.728592; [Epub ahead of print].Google Scholar
  84. 84.
    Bakker MJ, van Dijk JG, van den Maagdenberg AM, Tijssen MA. Startle syndromes. Lancet Neurol. 2006;5:513.PubMedGoogle Scholar
  85. 85.
    Zhou L, Chillag KL, Nigro MA. Hyperekplexia: a treatable neurogenetic disease. Brain and Development. 2002;24:669.PubMedGoogle Scholar
  86. 86.
    Giacoia GP, Ryan SG. Hyperekplexia associated with apnea and sudden infant death syndrome. Arch Pediatr Adolesc Med. 1994;148:540.PubMedGoogle Scholar
  87. 87.
    Praveen V, Patole SK, Whitehall JS. Hyperekplexia in neonates. Postgrad Med J. 2001;77:570.PubMedPubMedCentralGoogle Scholar
  88. 88.
    Seidahmed MZ, Salih MA, Abdulbasit OB, Shaheed M, Al Hussein K, Miqdad AM, Al Rasheed AK, Alazami AM, Alorainy IA. Alkuraya FS. A novel syndrome of lethal familial hyperekplexia associated with brain malformation. BMC Neurol. 2012;12:125.  https://doi.org/10.1186/1471-2377-12-125.CrossRefPubMedPubMedCentralGoogle Scholar
  89. 89.
    Blaes F, Dharmalingam B. Childhood opsoclonus-myoclonus syndrome: diagnosis and treatment. Expert Rev Neurother. 2016;16(6):641–8.  https://doi.org/10.1080/14737175.2016.1176914; Epub 2016 Apr 27.CrossRefPubMedGoogle Scholar
  90. 90.
    Pang KK, de Sousa C, Lang B, Pike MG. A prospective study of the presentation and management of dancing eye syndrome/opsoclonus-myoclonus syndrome in the United Kingdom. Eur J Paediatr Neurol. 2010;14:156.PubMedGoogle Scholar
  91. 91.
    Tate ED, Allison TJ, Pranzatelli MR, Verhulst SJ. Neuroepidemiologic trends in 105 US cases of pediatric opsoclonus-myoclonus syndrome. J Pediatr Oncol Nurs. 2005;22:8.PubMedGoogle Scholar
  92. 92.
    Hasegawa S, Matsushige T, Kajimoto M, et al. A nationwide survey of opsoclonus-myoclonus syndrome in Japanese children. Brain and Development. 2015;37:656.PubMedGoogle Scholar
  93. 93.
    Wells EM, Dalmau J. Paraneoplastic neurologic disorders in children. Curr Neurol Neurosci Rep. 2011;11:187.PubMedGoogle Scholar
  94. 94.
    Cross JH. Differential diagnosis of epileptic seizures in infancy including the neonatal period. Semin Fetal Neonatal Med. 2013;18(4):192–5.  https://doi.org/10.1016/j.siny.2013.04.003; Epub 2013 Apr 30. Review.CrossRefPubMedGoogle Scholar
  95. 95.
    Huntsman RJ, Lowry NJ, Sankaran K. Nonepileptic motor phenomena in the neonate. Paediatr Child Health. 2008;13(8):680–4.PubMedPubMedCentralGoogle Scholar
  96. 96.
    Parker S, Zuckerman B, Bauchner H, et al. Jitteriness in full-term neonates: prevalence and correlates. Pediatrics. 1990;85:17.PubMedGoogle Scholar
  97. 97.
    Frankel EA, Shalaby TM, Orenstein SR. Sandifer syndrome posturing: relation to abdominal wall contractions, gastroesophageal reflux, and fundoplication. Dig Dis Sci. 2006;51:635.PubMedGoogle Scholar
  98. 98.
    Kabakuş N, Kurt A. Sandifer syndrome: a continuing problem of misdiagnosis. Pediatr Int. 2006;48:622.PubMedGoogle Scholar
  99. 99.
    Sheikh S, Stephen TC, Sisson B. Prevalence of gastroesophageal reflux in infants with recurrent brief apneic episodes. Can Respir J. 1999;6:401.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Paediatrics and Child HealthAga Khan University, East AfricaNairobiKenya
  2. 2.Department of Paediatric Neurology, Red Cross War Memorial Children’s Hospital, Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa

Personalised recommendations