PAROXYSMAL NONEPILEPTIC EVENTS IN CHILDHOOD

Lj. Cvitanović-Šojat

Differentiating seizures from nonepileptic events frequently is challenging in children manifesting repetitive, stereotypic behaviour. An incorrect diagnosis of epilepsy was made in about 20-30% of children having episodes of abnormal behaviours. These events cause concern to parents and are frequently brought to the attention of physicians. When they are severe and recurrent, diagnostic evaluation is necessary. The aim of the study was the evaluation and description of most common spells in children that can be misdiagnosed as epilepsy. The most common nonepileptic paroxysmal conditions that causes faints and other turns are: syncopes, breath-holding spells, episodes of apnoea, benign paroxysmal vertigo, acute psychiatric manifestations, seizures of toxic origin, tetany due to hyperventilation or repeated vomiting, paroxysmal dyskinesias, excessive startle response, rhythmias, migraine, alternating hemiplegia of choldhood, paroxysmal disorders of sleep. Emphasis is placed on the importance of a thorough history, a complete general physical and neurological examination, including laboratory testing and cardiac evaluation, EEG records, video-EEG monitoring, polisomnography and psychological examination will result in a specific diagnosis. Recognition that other neurologically abnormal phenomena can closely mimic epilepsy is important for prevention of erroneous diagnoses of epilepsy and over treatment, and for avoidance of consequences on a child’s and family life.