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Misdiagnosis of epilepsy due to errors in EEG interpretation

Comprehensive Epilepsy Program, Departments of Neurology & Neurosurgery, University of South Florida and Tampa General Hospital, Tampa, Florida, USA; sbenbadi@health.usf.edu

The first 150 words of the full text of this article appear below.

CASE 1

A 33-year-old woman was evaluated for episodes of generalised weakness, fatigue, diffuse pain, and dizziness. Her EEG revealed "temporal sharp waves" (fig 1, arrow). Despite the history, she was diagnosed with seizures and started on antiepileptic drugs.

View larger version (129K):   Figure 1 These sharp transients arise from an ongoing rhythm of the same frequency. They do not clearly stand out or disrupt the background activity. Contrast this with the sharp waves shown in figure 3.

A 46-year-old woman was evaluated for a single episode of loss of consciousness after stepping out of her car. She recalled feeling unwell and weak, and then came to 1–2 minutes later with people around her. Witnesses said that she slumped down to the ground and was out and limp with no abnormal movements. EEG showed left temporal sharp waves "with phase reversals" (fig 2, arrow). Again despite the history, a diagnosis of seizures was made and . . . [Full text of this article]

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Charles Warlow
Practical Neurology 2007 7: 279. [Extract] [Full Text] [PDF]