OBJECTIVE: The etiological misinterpretation of paroxysmal neurological symptoms frequently causes a delayed treatment or an inappropriate utilization of ICU-capacities. METHODS: In this study, the data of 208 patients admitted to a neurological ICU because of acute transient neurological deficits, loss of consciousness or unclear motor phenomena were retrospectively analyzed. The initial emergency room diagnosis was compared to the final diagnosis and the rate of misdiagnosis was related to the patients' history and diagnostic data. RESULTS: In 13.9%, the emergency room diagnosis of epileptic seizures turned out to be incorrect, whereas in 15.6%, the final diagnosis of epileptic seizures was missed in the emergency room. Factors that were significantly correlated to missing the seizure diagnosis were (i) no prior history of epilepsy, (ii) old age, (iii) multi-morbidity, (iv) pathologic CT-scans demonstrating cerebrovascular lesions, (v) seizure description by non-professionals, (vi) predominantly negative seizure phenomena (aphasia, loss of consciousness, paresis), (vii) lack of tongue-bite lesions.
OBJECTIVE: The etiological misinterpretation of paroxysmal neurological symptoms frequently causes a delayed treatment or an inappropriate utilization of ICU-capacities. METHODS: In this study, the data of 208 patients admitted to a neurological ICU because of acute transient neurological deficits, loss of consciousness or unclear motor phenomena were retrospectively analyzed. The initial emergency room diagnosis was compared to the final diagnosis and the rate of misdiagnosis was related to the patients' history and diagnostic data. RESULTS: In 13.9%, the emergency room diagnosis of epilepticseizures turned out to be incorrect, whereas in 15.6%, the final diagnosis of epilepticseizures was missed in the emergency room. Factors that were significantly correlated to missing the seizure diagnosis were (i) no prior history of epilepsy, (ii) old age, (iii) multi-morbidity, (iv) pathologic CT-scans demonstrating cerebrovascular lesions, (v) seizure description by non-professionals, (vi) predominantly negative seizure phenomena (aphasia, loss of consciousness, paresis), (vii) lack of tongue-bite lesions.
Authors: Susan T Herman; Nicholas S Abend; Thomas P Bleck; Kevin E Chapman; Frank W Drislane; Ronald G Emerson; Elizabeth E Gerard; Cecil D Hahn; Aatif M Husain; Peter W Kaplan; Suzette M LaRoche; Marc R Nuwer; Mark Quigg; James J Riviello; Sarah E Schmitt; Liberty A Simmons; Tammy N Tsuchida; Lawrence J Hirsch Journal: J Clin Neurophysiol Date: 2015-04 Impact factor: 2.177
Authors: Philipp S Reif; Laurent M Willems; Adam Strzelczyk; Karl Martin Klein; Felix Rosenow Journal: Herzschrittmacherther Elektrophysiol Date: 2018-05-14