Abstracts

Rationale: Many common disorders and even normal phenomena may mimic epileptic seizures. Over- diagnosis of epilepsy is a serious problem leading to the undue use of antiepileptic medications and depriving the patient from the opportunity to receive proper management. Methods: The study aimed at identifying the most common conditions misdiagnosed as epilepsy among the cases referred for Pediatric neurology consultation in king Fahd Hospital of the University- Al Khobar- KSA during a period of one year. During the period of one year, from March 2008 till March 2009, 41 patients referred with the diagnosis of epilepsy proved to be non epileptic, their ages ranged from 2 months to 10 yrs. Results: Benign neonatal sleep myoclonus, acute life threatening events most commonly due to aspiration and gastroesophageal reflux, breath-holding spells, pallid attacks, spasmus nutans and shaken baby syndrome were the causes for misdiagnosis during early infancy. Syncope, self stimulating behaviours and stereotypies, encephalopathies, paroxysmal sleep disorders, psychogenic non-epileptic attack, and hyperekplexia were the causes in the older age group. Developmental delay, dysmorphic facies, interpretation of the initial EEG by adult neurologist, order of birth and young age of the mother were factors found to be more commonly associated with misdiagnosis of epilepsy in the pediatric age group. Conclusions: Thorough history taking and encouragement of parents to video tape the attacks as well as careful interpretation of EEG and defining what should be considered as abnormal EEG pattern in the pediatric age group are key factors to prevent diagnosis of epilepsy where none exists.