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Chapter 12 - Seizure Mimics

from Part II - Case-Based Approach to Specific Conditions

Published online by Cambridge University Press:  22 February 2024

Neville M. Jadeja  and
Kyle C. Rossi
Neville M. Jadeja
Affiliation:
University of Massachusetts Medical School
Kyle C. Rossi
Affiliation:
University of Massachusetts Medical School
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Summary

This chapter uses a case-based approach to describe a few common seizure mimics that may be mistaken for epileptic seizures in critically ill patients. These include tremors, myoclonus, syncope, and functional seizures (psychogenic non-epileptic seizures). Tremors appear as rhythmic or periodic activity but may be differentiated from seizures by the lack of a definite field and stereotyped pattern without evolution. Myoclonus refers to body or limb jerking movements that may be confused with seizures. Myoclonus may be of cortical or subcortical origin. Cortical myoclonus is associated with time-locked epileptic discharges, whereas subcortical myoclonus lacks an epileptic correlate though myogenic artifact may be seen. Convulsive syncope and non-epileptic psychogenic seizures are also described along with their electrographic patterns.

Keywords

tremorsmyoclonussyncopefunctionalseizurespyschogenicnon-epileptic attacksspells
Type
Chapter
Information
Critical Care EEG Basics
Rapid Bedside EEG Reading for Acute Care Providers
 , pp. 169 - 181
Publisher: Cambridge University Press
Print publication year: 2024

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References

Herman, ST, Abend, NS, Bleck, TP, et al. Consensus statement on continuous EEG in critically ill adults and children, Part I: Indications. Journal of Clinical Neurophysiology. 2015 Apr;32(2):87.Google Scholar
Sutter, R, Ristic, A, Rüegg, S, Fuhr, P. Myoclonus in the critically ill: Diagnosis, management, and clinical impact. Clinical Neurophysiology. 2016 Jan 1;127(1):67–80.Google Scholar
Brenner, RP. Electroencephalography in syncope. Journal of Clinical Neurophysiology. 1997 May 1;14(3):197–209.Google Scholar
Oto, M, Reuber, M. Psychogenic non-epileptic seizures: Aetiology, diagnosis, and management. Advances in Psychiatric Treatment. 2014 Jan;20(1):13–22.Google Scholar

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  • Seizure Mimics
  • Neville M. Jadeja, University of Massachusetts Medical School, Kyle C. Rossi, University of Massachusetts Medical School
  • Book: Critical Care EEG Basics
  • Online publication: 22 February 2024
  • Chapter DOI: https://doi.org/10.1017/9781009261159.015
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  • Seizure Mimics
  • Neville M. Jadeja, University of Massachusetts Medical School, Kyle C. Rossi, University of Massachusetts Medical School
  • Book: Critical Care EEG Basics
  • Online publication: 22 February 2024
  • Chapter DOI: https://doi.org/10.1017/9781009261159.015
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Seizure Mimics
  • Neville M. Jadeja, University of Massachusetts Medical School, Kyle C. Rossi, University of Massachusetts Medical School
  • Book: Critical Care EEG Basics
  • Online publication: 22 February 2024
  • Chapter DOI: https://doi.org/10.1017/9781009261159.015
Available formats
×