Paroxysmal nonepileptic disorders: differential diagnosis of epilepsy
Sheila J Wallace, Kevin Farrell in Epilepsy in Children, 2E, 2004
A significant proportion of children suspected of having epilepsy, and even those with a definite diagnosis of epilepsy or even refractory epilepsy, have never had an epileptic seizure. Misdiagnosis rates are high throughout the world, irrespective of the wealth and resources available to the health-care system. The principal reason for this is that the diagnosis of epilepsy will always be dependent on the difficult, lonely, art of history taking. The physician taking the history must have an expertise in recognizing the clinical features of all the myriad forms of epileptic seizures, but this must be combined with an equally expert knowledge of those paroxysmal disorders that may mimic epilepsy. Most of the patients presenting to a first seizure or epilepsy clinic will not have epilepsy, and this alone justifies the place of this chapter in a book on epilepsy.
Substance misuse
Emma C Fergusson, Tom Clark, Ed Day in Core Clinical Cases in Psychiatry, 2005
A 49-year-old bricklayer attended his GP’s surgery after experiencing an epileptic seizure. Approximately 5 years previously he had noticed that his hands were shaky in the morning. This would last until lunchtime, when he would drink five or six pints of beer in the pub with his work colleagues. At this point the shakiness would settle and he would feel much better. His daily intake of beer had gradually increased over several years, and he always kept an alcoholic drink beside the bed to have when he woke up to ‘steady his nerves for the day ahead’. He had noticed some numbness in both feet, and had brought up some fresh blood whilst retching. His friends commented that his memory was poor, and he wondered whether his skin might have a yellowish tinge to it.
Substance misuse
Tom Clark, Ed Day, Emma Fergusson in Core Clinical Cases in Psychiatry, 2011
CASE 8.1 – Heavy drinking A 49-year-old bricklayer attended his general practitioner (GP) after experiencing an epileptic seizure. Approximately 5 years previously he had noticed that his hands were shaky in the morning. This would last until lunchtime, when he would drink five or six pints of beer in the pub with his work colleagues. At this point the shakiness would settle and he would feel much better. His daily intake of beer had gradually increased over several years, and he always kept an alcoholic drink beside the bed to have when he woke up to ‘steady his nerves for the day ahead’. He had noticed some numbness in both feet, and had brought up some fresh blood while retching. His friends commented that his memory was poor, and he wondered whether his skin might have a yellowish tinge to it.
Epilepsy detection from EEG signals: a review
Published in Journal of Medical Engineering & Technology, 2018
Over many decades, research is being attempted for the detection of epileptic seizure to support for automatic diagnosis system to help clinicians from burdensome work. In this respect, an enormous number of research papers is published for identification of epileptic seizure. It is difficult to present a detailed review of all these literature. Therefore, in this paper, an attempt has been made to review the detection of an epileptic seizure. More than 100 research papers have been discussed to discern the techniques for detecting the epileptic seizure. Further, the literature survey shows that the pattern recognition required to detect epileptic seizure varies with different conditions of EEG datasets. This is mainly due to the fact that EEG detected under different conditions has different characteristics. This is, in turn, necessitates the identification of pattern recognition technique to effectively distinguish EEG epileptic data from a various condition of EEG data.
EEG-based epileptic seizure detection using GPLV model and multi support vector machine
Published in Journal of Information and Optimization Sciences, 2020
Epilepsy is chronic neurological disorder that is clinically detected by continuous monitoring of Electroencephalogram (EEG) signals by experienced clinicians. Epilepsy is detected by clinicians based on the visual observation of EEG records that normally consumes more time and sensitive to noise. To address these issues, a new system is proposed for automatic epileptic seizure recognition. Gaussian Process Latent Variable Model (GPLVM) is used to lessen the number of features by achieving a set of principal features that significantly rejects the “curse of dimensionality” concern. Then, a supervised classifier (Multi Support Vector Machine (MSVM)) is used to classify the epileptic seizure classes such as normal, ictal, and interictal. Experimental result exemplifies that the proposed work effectively classifies the epileptic seizure classes in light of sensitivity, specificity, False Positive Rate (FPR), False Negative Rate (FNR), and accuracy. The proposed work improves the classification accuracy upto 2.5-12% related to the existing works. The proposed work delivers a new avenue for assisting clinicians in diagnosing epileptic seizure.
Relationship between generalized epileptic seizure and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and neutrophil mediated inflammation
Published in International Journal of Neuroscience, 2020
Muzaffer Güneş, Hüseyin Büyükgöl
Aim: There is a close relationship between systemic inflammation and epileptic seizure. Recently, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been defined as significant inflammation biomarkers. In the present study, it was aimed to determine levels of NLR, PLR, and mean platelet volume (MPV) during generalized tonic clonic epileptic seizures, and to investigate their relationships with epileptic seizures. Methods: The present study was conducted on 72 patients with epilepsy who applied with primary and secondary generalized tonic clonic epileptic seizures according to classification of the International League Against Epilepsy (ILAE), and 72 healthy individuals as the control group. Neutrophil and lymphocyte counts, NLR, PLR, and MPV values of patients were evaluated both in acute (in the first hour of epileptic seizure) and subacute (in hour 72 of epileptic seizure) phases by biochemical analysis. Results: Statistically significant differences were determined in laboratory values of white blood cell (WBC) (p < 0.001), neutrophil (p < 0.001), lymphocyte (p < 0.001), NLR (p < 0.001), MPV (p < 0.05), platelet (p < 0.001), C-reactive protein (CRP) (p < 0.05) in acute phase; and in lymphocyte (p < 0.05), NLR (p < 0.05), platelet (p < 0.001), and CRP (p < 0.001) in subacute phase between patients and healthy controls. Statistically significant differences were determined in laboratory values of WBC (p < 0.001), neutrophil (p < 0.001), lymphocyte (p < 0.05), NLR (p < 0.001), CRP (p < 0.001), and PLR (p < 0.05) in patient group between acute and subacute phases. In patient group, mean lymphocyte count was determined lower in acute phase than subacute phase (p < 0.05). Conclusion: The most striking finding of the present study is determination of 1 unit increase in NLR results in 1.95 folds increase in epileptic seizure risk in binary logistic regression analysis. Additionally, it indicates that epileptic seizure is correlated with NLR, PLR, and neutrophil mediated inflammation. To the best of authors knowledge, this is the first report indicating that there is a relationship between epileptic seizure and PLR, neutrophil mediated inflammation, and that 1 unit increase in NLR increases epileptic seizure risk by 1.95 folds.
Related Knowledge Centers
- Epilepsy
- Electroencephalography
- Partial Seizure