Current approach to differential diagnosis of epileptic seizures and pseudo-seizures

Abstract

Epileptic seizure is the emergence of various transient signs and symptoms resulting from abnormal excessive electrical discharges and synchronous activity. Pseudoseizure can be defined as clinical events that resemble epileptic attacks which are not associated with central nervous system dysfunction. It is difficult to differentiate between pseudoseizures and epileptic seizures. Treatment of pseudoseizures like epileptic seizures causes the use of unnecessary and inappropriate antiepileptic medications. Patients refer to emergency polyclinics again and again, and examinations are repeated needlessly. Therefore, their life quality deteriorates and this situation causes economic burden at the same time. In this article, we investigate the clinical features, EEG findings, biological parameters and autonomic neural system tests that should be looked out for in order to differentiate between epileptic seizures and pseudoseizures in conjunction with the latest literature studies.

Keywords

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Epileptik nöbet ve psödonöbetlerin ayırıcı tanısına güncel yaklaşım

Öz

Epileptik nöbet; anormal aşırı elektriksel deşarjlara ve eşzamanlı nöronal aktiviteye bağlı çeşitli bulgu ve işaretlerin geçici olarak ortaya çıkmasıdır. Psödonöbet; santral sinir sistemi disfonksiyonu ile ilişkisi olmayan, epileptik ataklara benzeyen klinik durumlar olarak tanımlanabilir. Psödonöbetlerin epileptik nöbetlerden ayırımı zordur. Psödonöbetlerin epileptik nöbet gibi tedavi edilmesi gereksiz ve uygunsuz antiepileptik kullanımına neden olmaktadır. Hastalar defalarca acil polikliniklere başvururlar, gereksiz yere tetkikler tekrarlanır; dolayısı ile yaşam kalitelerinde bozulmanın yanısıra ekonomik olarak da yük haline gelirler. Biz bu yazıda epileptik nöbetlerle psödonöbetlerin ayırımında dikkat edilmesi gereken klinik özelikler, EEG bulguları ve biyolojik parametreleri, otonom sinir sistemi testlerini son literatür çalışmaları eşliğinde inceledik.

Anahtar Kelimeler

• Epilepsi, psödonöbet, ayırıcı tanı

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