Epilepsy
 Home | Free Epilepsy Articles | Links | | Contact
Epilepsy articles
Epilepsy Is One Of The Most Common Disorders Of The Nervous System. There Are Many Misconceptions About Epilepsy. That's Where We Come In. Welcome To Epileptic Seizure Disorder.com. This Site Is A Free Information Resource That Will Answer All Your Questions About Epilepsy And Seizure Disorder. As You Explore This Site, You'll Discover...

Revealed: 10 Tips For People With Epileptic Seizures   Seizures: Have You Been A Victim Of People's Ignorance?   The Musical Myth: Does Music Really Impact Epilepsy   She Ignored Her Symptoms And Nearly Killed 3 People  

Remember... If You Are Looking For Quality Information Related To Epilepsy, Add This Site To Your Favorites Right Now, As We Update It Daily With The Latest News And Information Related To Epilepsy And Similar Topics. Enjoy The Site.

Everything You Must Know About Epilepsy, Seizure Disorder, Cheap Diazepam, Epilepsy Treatment, And Epilepsy Seizures.

Recommended Epilepsy Resources

Press  For A Message
Latest Related Articles About Epilepsy
Epilepsy: Ignore It and You Are Dead
I ignored my symptoms of epilepsy, and nearly killed three people. One morning I offered to drive my youngest brother and nephew to the...
Continue Reading

Just what are we thinking?
We don't take our medicine correctly, we skip out of blood tests and doctors visits, we don't excercise and ignore diet guidelines. No wonder we're...
Continue Reading

Side Effects of Alprazolam
Side effects caused by Xanax/Alprazolam tablet or bars may be generally observed at the beginning of therapy and usually disappear when the anxiety...
Continue Reading

Looking For More Articles Related To Epilepsy?




Epilepsy
Poll

 
 
Share &
Enjoy:
| Send To A Friend
 
  Diagnosing Spells: Fits, Faints and More

Author:
Gary Cordingley

Spells. Things that go bump in the night. Such events are medical mysteries in need of solving. As a consulting neurologist, I've learned that part of my job is to be a "phenomenologist." To explain, if possible, the unexplained. To puzzle out mystery-symptoms and odd phenomena.

And one of the hardest (but most intellectually stimulating) diagnoses to make is that of "spells." That's what I call episodes that come and go, that have a beginning and an end—and something unusual in between. The basic process of diagnosing spells should be familiar to anyone who has taken a squeaking car to a mechanic. The one time that the car doesn't squeak is when the mechanic is inspecting it. So the mechanic has to make an analysis based on what you describe.

The same thing occurs in diagnosing people with spells. When an attack occurs in front of a doctor, it's usually easy to diagnose. But that almost never happens. Usually, all we have to go on is the description, or, hopefully, two descriptions—one from the person who had the spell and a second from someone else who was there to witness it.

Methodically, each of the two accounts is broken down into three parts—the events leading up to the attack, the attack itself, and what happened afterwards. Each account, taken one at a time, is based on what that person actually saw, heard and could remember, reported in a way particular to that person's abilities to observe and articulate. To make matters more challenging, the patient who had the attack often has significant gaps in their memory.

The list of potential underlying causes—what I think of as the differential diagnosis of things that come and go—spans multiple medical disciplines and is almost as broad as medicine itself. For example, let's assemble just a short list of conditions that can occur as episodic symptoms: seizures, pseudoseizures (seizure-like attacks of psychological origin), fainting spells, hypoglycemia, panic attacks, irregular heartbeats, dissociations, transient ischemic attacks (TIAs), migraine and vertigo.

What a list! It includes items from the fields of neurology, cardiology, psychiatry, endocrinology and otorhinolaryngology . And a physician is likely to run into each of these conditions at one time or another. Unfortunately for the purposes of diagnosis, patients don't arrive at clinics wearing signs around their necks saying, "I have a psychiatric condition," or, "My symptoms are due to my heart." All they know is that they have a problem they need help with.

Much of medical diagnosis is "pattern fitting" in which the patient's story is matched up against typical stories told by patients with different, identified conditions, and the best fit wins. Or, said another way: if it looks like a duck, walks like a duck and quacks like a duck, then it must be a duck.

But what if it looks like a duck, walks like a goose and gobbles like a turkey? What is it then? Well, that's what we call an outlier or atypical case, and we just do the best we can.

Medical tests are available for some of these conditions, like an electroencephalogram (EEG) for seizure cases, a 5-hour glucose tolerance test for hypoglycemia, and prolonged cardiac monitoring for irregular heartbeats. But each of these tests has its own strengths, weaknesses, and blind-spots that need to be figured into the diagnosis. (For example, an EEG might be normal in a patient who really does have seizures.) Then, for some of the conditions—like panic attacks, migraines and pseudoseizures—corroborating tests don't even exist.

Sometimes the available data permit a confident diagnosis and a specific treatment. In other cases the data allow one to narrow the possibilities to a short list, but not a single, final, definitive diagnosis. What then?

Sometimes watchful waiting is what's called for, also known as tincture of time. Once every obtainable clue has been assembled and they're still not enough to permit a firm diagnosis, then perhaps the best clue just hasn't happened yet and needs to be waited for.

Depending on which items are still on the diagnostic short-list, treatment might still be possible. For example, in a case in which it can't be decided if a patient has seizures, pseudoseizures, or both, it might be reasonable to try a decent dose of a good seizure-preventing drug, and watch to see if anything changes for the better.

Reading about inexactness in medical diagnosis might make some people uneasy. Perhaps it would be more comforting to believe that "a series of tests" could prove any diagnosis. For many conditions I'm sure that's exactly what happens, but it doesn't seem to be true for things that go bump in the night.

(C) 2005 by Gary Cordingley

About the Author
Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher. For more health-related articles see his website at:
http://www.cordingleyneurology.com

Share &
Enjoy:
| Send To A Friend
 
 

Article Keywords:
Epilepsy


Google






A Quick Note From The Publisher...

If you like the article above, you may be interested in the following article which is also related to Epilepsy...

115 Americans will die unnecessarily TODAY
Epilepsy claims up to 42,000 American lives each year. Up to 40 percent of these could be prevented with better care and treatment, a UK audit reveals. Shocking statistics have come to light through research into epilepsy related deaths. U.S. deaths are estimated at 22,000 to 42,000 per year – mostly due to shortfalls in the care and treatment of people with epilepsy. According to a UK audit conducted in May 2002, the death toll could be reduced by up to 40 percent with proper research and increased awareness. However, very few additional programs have been created since the audit. Up to 115 people will still die unnecessarily today, up to 16,800 preventable deaths this year.     Half of all epilepsy related deaths are caused by prolonged seizures and accidents resulting from them. The other half, worryingly, are attributed to SUDEP (Sudden Death in Epilepsy). Experts assume these deaths are related to the victim’s...
Continue Reading

 

Epilepsy,

Seizure Disorder
News

Epilepsy

EpilepticSeizureDisorder.com - All Rights Reserved. Legal Information
Featuring Information About Epilepsy, Seizure Disorder, Cheap Diazepam, Epilepsy Treatment, And Epilepsy Seizures.
Geo Visitors Map