Abstracts

Rationale: The diagnosis of epilepsy depends heavily on detailed history and timely observation. Several non-epileptic causes of paroxysmal events can be confused with recurrent seizures (epilepsy mimickers). These include gastro-esophageal reflux, breath holding spells, self-gratification, movement disorders, and others.  Methods: Case series Results: We present four children, aged 2-5 years, who were initially misdiagnosed as epilepsy and referred because of lack of control on multiple antiepileptic drugs. They would adopt positions and have facial features that mimic motor seizures. Clinical re-evaluation revealed that these events were the result of frequent anal spasms that occurred as the child was trying to withhold defecation. Severe chronic functional constipation was documented in all of them resulting in painful defecation and soiling. Anal fissure contributed to the painful anal spasms in most cases. All abnormal movements resolved by appropriate stool softeners.  Conclusions: Recurrent anal spasms due to stool withholding should be considered as one of the epilepsy mimickers.  Funding: None