Rapid Responses to:

NEWS: Caroline White Rate of misdiagnosis of childhood epilepsy "may not be unusual" BMJ 2003; 326: 355c [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Misdiagnosis in chldhood epilepsy

Keith L Meloff MD, FRCPC, c/o 36 Burton Rd. Toronto,Ontario M5P 1V2   (15 February 2003)

Misdiagnosis in chldhood epilepsy 15 February 2003
Keith L Meloff MD, FRCPC, Adjunct Professor of Pediatrics(Neurology) University of Western Ontario,London Ontario, c/o 36 Burton Rd. Toronto,Ontario M5P 1V2 Send response to journal: Re: Misdiagnosis in chldhood epilepsy	The diagnosis of "epilepsy" in children is often difficult. Among many difficulties, there are basic semantic issues of distinguishing epilepsy, a recurrent tendency to seizures due to some irritative brain disorder, from benign seizures including "febrile" seizures, seizures due to syncope(inclding breath-holding spells) and other mimics such as confusional migraine and cyclical vomiting to mention but a few. Indeed, the challenge is to separate the true seizure disorder from its many imitators and sometimes co-conspirators! For example, it is possible that a child can have both confusional migraine and occipital epilepsy,both of which may be associated with transient distubances of vision during the "attack". It is a rare pediatric neurologist who achieves perfection in this complicated business. One may reduce,but not eliminate, errors with excellent electroencephalography including video- monitoring, by repeat history-taking,by meticulous physical examination( e.g. looking for abnormal skin pigment)by using MR imaging, and, most of all,by listening closely and carefully to mothers and teachers of the infant or child in question. Competing interests:   None declared