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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Neurocardiogenic syncope: frequency and consequences of its misdiagnosis as epilepsy.
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Neurocardiogenic syncope: frequency and consequences of its misdiagnosis as epilepsy.

机译：神经源性晕厥：频率和其误诊为癫痫的后果。

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摘要

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.
机译：背景：神经性心源性晕厥（NCS）可被误认为是癫痫发作。我们回顾了这种误诊的频率和诊断后果。方法：回顾性回顾了成人门诊癫痫病临床图（QEII健康科学中心，哈利法克斯，新南威尔士州），以鉴定NCS患者并诊断为癫痫发作。对图表进行了详细审查，重点放在误诊的后果上。结果：在1506个连续转诊至癫痫诊所的患者中，有194个（12.9％）最终被诊断为NCS。平均年龄为38 +/- 16岁（晕厥发作的平均年龄为28 +/- 16岁）。三分之二的转诊来自初级保健医生（包括急诊科），而18％的转诊来自神经科医生。在转诊之前，有35％的患者处方了抗癫痫药（AED），其中有8位（4.1％）出现超敏反应。五分之三的妇女在服用AED时有不良的妊娠结局。三分之一的患者对驾驶特权有限制，而11位患者（5.7％）的工作被中断。检查中使用的诊断方式包括EEG（90％），CT头（51％）和MRI头（15％）。结论：NCS通常被误诊为癫痫病。一些患者的错误诊断超过10年。患有这种误诊的患者通常会进行过多的检查，治疗不当，并对驾驶和就业施加不必要的限制。

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