Reliability of the early syndromic diagnosis in adults with new-onset epileptic seizures: A retrospective study of 116 patients attended in the emergency room

Seizure : the Journal of the British Epilepsy Association
E Fonseca HernándezM Toledo

Abstract

New-onset seizures (NOS) are a common reason for emergency department (ED) consultations. Decisions regarding treatment and further examinations are made based on the initial evaluation. We aimed to evaluate the reliability of the early syndromic diagnosis in NOS and find predictive factors to establish a consistent early diagnosis based on the semiology and prompt supplementary examinations. We recruited patients attended in our ED for NOS over 2 years (2014-2015), excluding patients with a loss of consciousness of suspected non-epileptic origin. All patients were assessed by a neurologist. A baseline diagnosis was established according to clinical findings and neuroimaging/EEG data. Over 1 year of follow-up in our Epilepsy Unit, a definite diagnosis was made based on clinical progress and further examinations. 116 patients were recruited (mean age 56.5 ± 22.1 years; 50% women). 47% were seizures of unknown cause. The concordance index between the baseline and definite diagnosis was κ = 0.662 (the diagnosis changed during follow-up in 25% of patients). Focal epilepsy of unknown cause was the baseline diagnosis that most often changed at follow-up (diagnostic change, 41.2%; p < 0.001). Lesions detected on CT-scanning and EEG ab...Continue Reading

References

Mar 1, 1992·Archives of Neurology·C A van DonselaarA C Declerck
Jul 1, 1982·The American Journal of Medicine·S C DayL Goldman
Feb 22, 2008·Epilepsia·Bernd Pohlmann-Eden, Mark Newton
Feb 20, 2008·Seizure : the Journal of the British Epilepsy Association·Heather Angus-Leppan
Apr 16, 2014·Epilepsia·Robert S FisherSamuel Wiebe
Jul 30, 2015·Epilepsia·Nicholas LawnJohn Dunne
Dec 27, 2016·Seizure : the Journal of the British Epilepsy Association·Maria Meritxell Oto

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Citations

Nov 4, 2021·Der Nervenarzt·Bert-Ulrich KleineJörg Berrouschot

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