The following document is the draft for my literature review. In order to organize my thoughts, I used a bullet point outline format. With the ideas for my headers nearly set in stone, it was easy for me to go through the articles and pinpoint specific areas from each one that fit into the specific heading. The abstract was left empty because that was the last paragraph that was written for this piece.
Misdiagnosis of Epilepsy: A Literature Review
ABSTRACT
INTRODUCTION
Epilepsy is a serious condition thatwhich has different symptoms, among which seizure is the most common. The disturbance in brain activity that is caused by the symptoms of epilepsy can be harmful to the body and brain. Therefore, once an epileptic diagnosis is made, actions for treatment should be taken right away. Epilepsy can be treated with differentTreatment for epilepsy can be different anti-epilepsy medication. While epilepsy is a very serious condition, there are accounts of common misdiagnosis of epilepsy. Misdiagnosis of epilepsy can occur in two waysbe seen in two forms: one is diagnosing a condition as epilepsy, when it is not, or diagnosing a different condition as nother condition when it is epilepsy. In this literature review, multiplea different number of studies will be analyzed and compared to target which factors contribute to the common misdiagnosis of epilepsy. The aim is to pinpoint those factors and identify a possible solution so that the rate of misdiagnosis can be reduced. This topic is of great importance because a misdiagnosis of epilepsy can have many detrimentalundiscovered implications for the patient receiving the wrong diagnosis. When thinking of the importance of treatment for epilepsy, a possible implication of misdiagnosis is that a person will not receive the proper treatment for their conditionthe treatment they possess- whether it be epilepsy or another condition. Additionally, a person beingcan be treated for epilepsy will suffer unwanted side effects from the medication which can possibly be detrimental to their healthan illness they do not have and experience unknown side effects. With the analysis of the main factors leading to the misdiagnosis of epilepsy, the implications can be known, and a possible solution can be established.
ANALYSIS
Common Non-Epileptic Events Confused with Epilepsy
· Syncope is the most common non-epileptic event that is mistaken with epilepsy (Hindley 2006; Fattouch et al 2007).
Lack of Knowledge about Different Symptoms *These two might work hand in hand, because it deals with differing symptoms that can be confused with each other*
Misinterpretation of Clinical Data: EEGs, MRI, and Patient History
· The article states that getting a good reading on an EEG is very difficult in clinical setting that are not specialized in epilepsy. (Uldall et al 2006)
· 21 out of the 30 SMS patients showed abnormal EEGs and 11 out of 30 showed some alteration in their MRI findings. In the US group, 9 out of 27 had EEG abnormality and only 1 had an MRI alteration. (Fattouch 2007)
Doctors’ Certainty of Diagnosis:
· The certainty of a doctor on the diagnosis they are giving can deter from the right diagnosis being given (*alternate sentence: … can deter from the proper steps being taken to reach confirmation of an intended diagnosis).
o Some doctors underestimate symptoms because they don’t want to give a harsh diagnosis such as epilepsy for symptoms they are unclear of, to then have to retract it. So they prefer to label it as not being epilepsy
CONCLUSION
Understood Implications?
*Maybe this should be my conclusion?* Possible Solution: Referrals to epilepsy centers before making a definite diagnosis
· that centers that do not specialize in epilepsy will have a harder time in properly diagnosing epilepsy and syncope because of the misinterpretation of clinical, EEG, and neuroimaging results. (Fattouch 2007)
· The article states that getting a good reading on an EEG is very difficult in clinical setting that are not specialized in epilepsy. (Uldall et al 2006)
o Since misinterpretation of EEGs and other clinical tests might have occurred or are very difficult in areas not specialized for epilepsy, then it can be inferred that a possible solution to the misdiagnosis of epilepsy is the referral to epilepsy centers before an epilepsy diagnosis is made.
· “if the cause of a ‘funny turn’ is unclear, it is better to err on the side of ‘not epilepsy’ and subsequently correct that decision than to give the label of ‘epilepsy’ and try to retract it”.( O’Donohoe 1994 cited by Hindley 2006)
References:
Fattouch J., Di Bonaventura C., Strano S., Vanacore N., Manfredi M., Prencipe M., Giallonardo A.T. 2007. Over-interpretation of electroclinical and neuroimaging findings in syncope misdiagnosed as epileptic seizures. Epileptic Discord. 9(2)(170-173) [Internet][Accessed May 8 2019]
Available from: https://pdfs.semanticscholar.org/d2f5/2e5e508d5cb5fbae52f1d0256a4759220345.pdf
Hindley D., Ali A., Robson C. 2006. Diagnoses made in a secondary care “fits, faints, and funny turns” clinic. ADC. 91(3)(214-218). [Internet] [Accessed April 15 2019]
Available from: https://adc-bmj-com.clinical-proxy.libr.ccny.cuny.edu/content/91/3/214
Murthy JM. 1999. Factors of error involved in the diagnosis of juvenile myoclonic epilepsy: a study from South India. Neurology India. 47(3)(210-213). [ Internet] [Accessed April 13 2019]
Available from: http://www.neurologyindia.com/article.asp?issn=0028-3886;year=1999;volume=47;issue=3;spage=210;epage=3;aulast=murthy
Uldall P., Alving J., Hansen L K., Kibaek M., Buchholt J. 2006. The misdiagnosis of epilepsy in children admitted to a tertiary epilepsy centre with paroxysmal events. ADC. 91(3)(219-221). [Internet] [Accessed April 10 2019]
Available from: https://adc-bmj-com.clinical-proxy.libr.ccny.cuny.edu/content/91/3/219
