Non Epileptic Seizures.



It Is Very Important To Know That 20% Of Seizures are Non Epileptic. With The Exception Of Prolactin, There Is No Biological Test To Diagnose Epilepsy. The EEG Who Is The Main Tool To Diagnose Epilepsy Could Be Abnormal In 5 % Of Normal People. Also Not Every Paroxysmal Phenomenon Of Cerebral Origin Is Epileptic In Nature , Like , For Example, Startle Disease.

Syncope, Sometimes, May Occur In Individuals Who Are Recumbent .

Patients With Asthma During an Acute Attack May Have Not Only Cerebral Ischemia, But They Also May Present With Tonic Episodes, Whose Mechanisms Is Analogous To That Of Anoxic Convulsions.

Acephalgic Migraine ,Who Occur In Adult And Children, Is Often Not Accompanied By Headache, May Be Misdiagnosed As Epileptic Attack Or Intermittent Cerebral Ischemia .

After The Migraine Aura, However, The Patient May Have Convulsive Seizures, So -Called Intercalated Attacks. These Are Most Likely Related To Spreading Depression Crossing The Central sulcus, But Proof Of The Specific Mechanism Is Lacking .

Confusional Migraine May Also Result In an Epileptic Seizure Occurring During The Acute Event. Here Too, The Possibility Of Eventual Development Of Independent Epileptic Attacks Exists . Patients With Basilar Migraine Not Infrequently Present Difficult Diagnostic Problems But The Presence Of Diplopia, Ataxia And Nystagmus Should Help. However Patients With Basilar Migraine Also May Have Epileptic Events Or in Rare Instances Status Epilepticus.

The Unresponsiveness That Is Not Uncommon During Basilar Migraine Attacks May Be Interpreted As Loss Of Consciousness; However The Patient Generally Can Be Aroused By Vigorous Stimulation Only To Relapse Into Stupor When Stimulation Ceases.

In Addition To The Clinical Problems ,The Recognition That Migraine Aura May Be Manifested By Electroencephalographic Spike-Discharge (Usually Over Posterior Head Regions) May Lead To Diagnostic Difficulty.

The Patients With Hemiplegic Migraine And Coma Do Not Have Clear Epileptic Events. The Hallucinations That Occur As They Recover From The Coma Are Similar To Those Of Peduncular Hallucinosis Who Are Caused By Mesencephalic Lesions Or Abnormalities And Do Not Respond To Antiepileptic Drugs .

The Auditory Hallucinations Of The Deaf Or The Visual Hallucinations Of The Blind Are Occasionally Misinterpreted As Epileptic In Nature.

An Epileptic Twilight State Is Sometimes Suspected In Patients With Episodic Hypothalamic Dysfunction Or The Kleine -Levin Syndrome ;But The Presence Of Hallucinations, Excessive Sleep And Eating, Inappropriate Sexual Behavior, Disturbance of Awareness and Memory Without Loss Of Consciousness Should Lead To The Diagnosis.

It now Appears That Paroxysmal Nocturnal Dystonia Is Not an Entity That Can Be Distinguished From Partial Epilepsy Of Frontal Origin. Medical Control Is Difficult In Some Families. It Occurs In The Absence Of Visible Lesions And Most Likely Is Related To Regional Disorders Of Channel Function Or Other molecular Abnormalities As yet Unidentified .

In Alternating Hemiplegia Of Childhood, The Progressive Deterioration And The Lack Of Response To Antiepileptic Drugs Eventually Lead To The Diagnosis. Perhaps As Many As Half the Children Later Develop Epileptic Seizures as Well, And In Most Instances These Are Easily Controlled.

Benign Nocturnal Alternating Hemiplegia Is Not Associated With Mental Deterioration And Is Even More Clearly Migraine Related .

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