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IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2025-03-17 DOI:10.1016/j.yebeh.2025.110369

Giulia Battaglia , Vito Sofia , Gaetano La Delfa , Gaetano Cantalupo , Giuseppe Didato , Barbara Mostacci , Loretta Giuliano , on behalf of the Epilepsy and Gender Commission , Videoteca Commission of the Italian League Against Epilepsy LICE and Italian chapter of the ILAE

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引用次数: 0

摘要

目的癫痫发作可有多种临床表现，通常与其他疾病相似，被称为 "癫痫发作的模仿者"，因此鉴别诊断具有挑战性。其中，精神性非癫痫性发作（PNES）或功能性/解离性发作（FDS）在女性中尤为常见。本研究旨在通过观看几种阵发性事件的视频录像，评估不同的非癫痫科医生区分癫痫发作和模仿者的能力。我们还评估了医学专业和专业经验年限等变量是否会影响诊断的准确性。材料和方法向非癫痫科医生展示了十段经过授权的信息资料视频。其中五段视频描述了非癫痫事件，包括晕厥、过度运动障碍发作、惊厥、PNES/FDS 和快速眼动行为障碍。其余视频则以局灶性和全身性癫痫发作为特征。结果来自精神科（12.9%）、内科（12.9%）、神经外科（14.3%）、神经内科（14.3%）、急诊科（18.6%）、麻醉科（18.6%）和其他科室的 70 名专家（44 名男性，26 名女性）完成了一份匿名问卷，将每个事件分类为癫痫或非癫痫。(18.6%）和其他（7.1%）。平均年龄为 49.9 ± 8.7 岁；工作年限为 0-20 年的占 53%，21-40 年的占 47%。50.3%的病例正确识别了癫痫发作，而49.7%的病例误诊为非癫痫性阵发性事件。最准确识别的事件是强直阵挛发作（88.6%），而最常误诊的是 PNES/FDS（94.3%）。本研究强调了开展培训以充分诊断和随后正确处理这些病症的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Distinguishing epileptic seizures from imitators: A video-based evaluation of non-epileptologist physicians

Objectives

Epileptic seizures can present with various clinical manifestations, often resembling other conditions—referred to as “imitators of epileptic seizures”—making differential diagnosis challenging. Among them, psychogenic non-epileptic seizures (PNES) or functional/dissociative seizures (FDS) are particularly prevalent in females. This study aimed to evaluate the ability of various non-epileptologist physicians to distinguish epileptic seizures from imitators by viewing video recordings of several paroxysmal events. We also assessed whether variables, such as medical specialty and years of professional experience, could impact diagnostic accuracy.

Materials and methods

Ten video recordings of authorized informational material were presented to non-epileptologist physicians. Five videos depicted non-epileptic events, including syncope, hyperkinetic movement disorder episodes, cataplexy, PNES/FDS, and REM behavior disorder. The remaining videos featured focal and generalized seizures. Participants completed an anonymous questionnaire to classify each event as epileptic or non-epileptic.

Results

Seventy specialists (44 men, 26 women) from psychiatry (12.9%), internal medicine (12.9%), neurosurgery (14.3%), neurology (14.3%), emergency (18.6%), anesthesiology. (18.6 %) and others (7.1 %) were enrolled. The mean age was 49.9 ± 8.7 years; years of work experience were 0–20 years for 53 % and 21–40 years for 47 %. Epileptic seizures were correctly. recognized in 50.3% of cases, whereas non-epileptic paroxysmal events were. misdiagnosed in 49.7% of cases. The most accurately recognized event was tonic-clonic seizure (88.6%), while the most frequently misdiagnosed was PNES/FDS (94.3%).

Discussion and conclusion

Correctly diagnosing epileptic and non-epileptic paroxysmal events can be challenging when relying solely on video recordings. This study highlights the importance of implementing training for adequate diagnosis and subsequent correct management of these conditions.

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.