Non-epileptic seizure 2559343 215332842 2008-05-27T19:08:58Z DOI bot 6652755 Citation maintenance. You can [[WP:DOI|use this bot]] yourself! Please [[User:DOI_bot/bugs|report any bugs]]. '''Non-epileptic seizures''' are [[Paroxysmal attacks|paroxysmal]] events that mimic an [[epileptic seizure]] but do not involve abnormal, rhythmic discharges of cortical [[neuron]]s.<ref name="Ricker2003">{{cite book | editor = Joseph H. Ricker (ed) | year = 2003 | month = October | title =Differential Diagnosis in Adult Neuropsychological Assessment | publisher = Springer Publishing Company | pages = 109 | id = ISBN 0-8261-1665-5 }}</ref> They are caused by either [[physiology|physiological]] or [[Psychology|psychological]] conditions. The latter is discussed more fully in [[psychogenic non-epileptic seizures]]. ==Types== {{Unreferencedsection|date=July 2007}} ''Reflex anoxic seizures'' are a condition of the brain where the child may become pale and limp and cease breathing, only to recover a short time later. Anoxic seizures are caused by a reflex asystole of the heart due to increased vagal responsiveness. They are non-epileptic. ==Misdiagnosis== A wide spectrum of phenomena may resemble epileptic seizures, which may lead to people who do not have [[epilepsy]] being misdiagnosed. Indeed, a significant percentage of people initially diagnosed with epilepsy will later have this revised. In one study, the majority of children referred to a secondary clinic with "fits, faints and funny turns" did not have epilepsy, with syncope (fainting) as the most common alternative.<ref name="Hindley2006">{{cite journal | author=Hindley D, Ali A, Robson C | title=Diagnoses made in a secondary care "fits, faints, and funny turns" clinic | journal=Arch Dis Child | year=2006 | pages=214–8 | volume=91 | issue=3 | pmid=16492885 | doi=10.1136/adc.2004.062455}} (Free full text online)</ref> In another study, 39% of children referred to a tertiary epilepsy centre did not have epilepsy, with staring episodes in [[mentally retarded]] children as the most common alternative.<ref name="Uldall2006">{{cite journal | author=Uldall P, Alving J, Hansen LK, Kibaek M, Buchholt J | title=The misdiagnosis of epilepsy in children admitted to a tertiary epilepsy centre with paroxysmal events | journal=Arch Dis Child | year=2006 | pages=219–21 | volume=91 | issue=3 | pmid=16492886 | doi=10.1136/adc.2004.064477}} (Free full text online)</ref> In adults, the figures are similar, with one study reporting a 26% rate of misdiagnosis.<ref name="Smith1999">{{cite journal | author=Smith D, Defalla BA, Chadwick DW | title=The misdiagnosis of epilepsy and the management of refractory epilepsy in a specialist clinic | journal=QJM | year=1999 | pages=15–23 | volume=92 | issue=1 | pmid=10209668 | doi=10.1093/qjmed/92.1.15}} (Free full text online)</ref> ==Terminology== The International League Against Epilepsy (ILAE) define an '''epileptic seizure''' as "a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain."<ref name="Fisher2005">{{cite journal | author=Fisher R, van Emde Boas W, Blume W, Elger C, Genton P, Lee P, Engel J | title=Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). | journal=Epilepsia | volume=46 | issue=4 | pages=470–2 | year=2005 | pmid=15816939 | doi=10.1111/j.0013-9580.2005.66104.x}} (Free full text online).</ref> Epileptic seizures can occur in someone who does not have epilepsy – as a consequence of [[head injury]], drugs, toxins, [[eclampsia]] or [[febrile convulsions]], for example. Medically, when used on its own, the term '''seizure''' implies an '''epileptic seizure'''. The lay use of this word can also include sudden attacks of illness, loss of control, spasm or stroke.<ref name="Fisher2005"/> Where the physician is uncertain as to the diagnosis, the medical term '''paroxysmal event''' and the lay terms '''spells''', '''funny turns''' or '''attacks''' may be used. ==Causes== The various pathophysiological causes include: *[[Benign paroxysmal positional vertigo]] *[[Breath-holding spells]] of childhood *[[Cataplexy]] *[[Hyperekplexia]], also called '''startle syndrome''' *[[Hypoglycemia]] and associated [[neuroglycopenia]] *infantile gratification / masturbation (onanism)<ref name="ArchDisChild2004-Nechay">{{cite journal | author=Nechay A, Ross LM, Stephenson JB, O'Regan M | title=Gratification disorder ("infantile masturbation"): a review | journal=Arch Dis Child | year=2004 | pages=225–6 | volume=89 | issue=3 | pmid=14977696 | doi=10.1136/adc.2003.032102}} </ref> *[[Migraine]] *[[Narcolepsy]] *Non-epileptic [[myoclonus]] *[[Opsoclonus]] *[[Parasomnia]]s, including [[night terrors]] *Paroxysmal kinesiogenic [[dyskinesia]] *Repetitive or ritualistic behaviours *[[fainting|Syncope]] (fainting) *[[Tic]]s ==References== *[http://www.epilepsyfoundation.org/answerplace/Medical/seizures/types/nonepileptic/ Epilepsy Foundation article about non-epileptic seizures] *[http://www.e-epilepsy.org.uk/pages/articles/show_article.cfm?id=48 National Society for Epilepsy (UK) article on Non-epileptic attack disorder]. A slightly more technical article aimed at health professionals. ==Footnotes== <references /> ==External links== *[http://www.non-epilepticseizures.com Nonepileptic Seizures patient resource site] [[Category:Medical terms]] [[Category:Neurology]]