@article{ref1,
title="Neurocardiogenic syncope: frequency and consequences of its misdiagnosis as epilepsy",
journal="Canadian journal of neurological sciences",
year="2007",
author="Josephson, Colin B. and Rahey, Susan and Sadler, R. Mark",
volume="34",
number="2",
pages="221-224",
abstract="BACKGROUND: Neurocardiogenic syncope (NCS) can be mistaken as a seizure. We reviewed the frequency and diagnostic consequences of this misdiagnosis. METHODS: A retrospective review of outpatient adult epilepsy clinic charts (QEII Health Sciences Centre, Halifax, NS) was conducted to identify NCS patients referred with a provisional diagnosis of seizures. Charts were reviewed in detail with an emphasis on the consequences of misdiagnosis. RESULTS: Of 1506 consecutive referrals to the epilepsy clinic, 194 (12.9%) ultimately had a clinical diagnosis of NCS. Mean age was 38 +/- 16 years (mean age of syncopal onset was 28 +/- 16 years). Two-thirds of referrals were from primary care physicians (including emergency departments) and 18% from neurologists. Thirty-five percent were prescribed antiepileptic drugs (AEDs) prior to referral with eight patients (4.1%) experiencing hypersensitivity reactions. Three of five women had adverse pregnancy outcomes while taking AEDs. One-third of patients had restrictions placed on their driving privileges while 11 patients (5.7%) had their employment interrupted. Diagnostic modalities used in the work-up included EEG (90%), CT head (51%), and MRI head (15%). CONCLUSIONS: NCS is commonly misdiagnosed as epilepsy. Some patients had an incorrect diagnosis for > 10 years. Patients with this misdiagnosis are often excessively investigated, inappropriately treated, and have unnecessary restrictions placed on driving and employment.<p /><p>Language: en</p>",
language="en",
issn="0317-1671",
doi="",
url="http://dx.doi.org/"
}