Paroxysmal non-epileptic events vs epilepsy – what we know and where we are in medicine?

Authors

DOI:

https://doi.org/10.15584/ejcem.2024.1.1

Keywords:

epilepsy, non-epileptic seizure in childhood, paroxysmal non-epileptic events

Abstract

Introduction and aim. Paroxysmal non-epileptic events (PNEEs) are neurological conditions that include behavioral changes or disturbances of consciousness. The aim of the article is to compare individual paroxysmal non-epileptic events disorders, to indicate differences in their clinical picture and to discuss their differential diagnosis.

Material and methods. A review of the most common non-epileptic paroxysmal events is presented based on the available literature of PubMed and Google Scholar databases from 2000 to 2023.

Analysis of the literature. Depending on the age of the child, the nature and type of seizures are variable. Unfortunately, epilepsy is currently overdiagnosed, which results in the inclusion of antiepileptic drugs without the need to use them. This may be related to the immaturity of the central nervous system, malfunctioning of other organs or have a psychogenic background. In most cases, they do not require pharmacological treatment.

Conclusion. Paroxysmal non-epileptic events, due to the diverse and uncharacteristic clinical picture, pose a major diagnostic challenge. Because of the current overdiagnosis of epilepsy they should always bear in mind differential diagnosis. This is important because of the differences in the treatment of these disorders.

Downloads

Download data is not yet available.

References

Lagorio I, Brunelli L, Striano P. Paroxysmal Nonepileptic Events in Children: A Video Gallery and a Guide for Differential Diagnosis. Neurol Clin Pract. 2022;12(4):320-327. doi: 10.1212/CPJ.0000000000001171

Benbadis S. The differential diagnosis of epilepsy: a critical review. Epilepsy Behav. 2009;15(1):15-21. doi: 10.1016/j.yebeh.2009.02.024

Gates JR. Nonepileptic seizures: time for progress. Epilepsy Behav. 2000;1(1):2-6. doi: 10.1006/ebeh.2000.0029

Bye AM, Kok DJ, Ferenschild FT, Vles JS. Paroxysmal non-epileptic events in children: a retrospective study over a period of 10 years. J Paediatr Child Health. 2000;36(3):244-248. doi: 10.1046/j.1440-1754.2000.00496.x

Kotagal P, Costa M, Wyllie E, Wolgamuth B. Paroxysmal nonepileptic events in children and adolescents. Pediatrics. 2002;110(4):e46. doi: 10.1542/peds.110.4.e46

Perez DL, LaFrance WC Jr. Nonepileptic seizures: an updated review. CNS Spectr. 2016;21(3):239-246. doi: 10.1017/S109285291600002X

Leung AKC, Leung AAM, Wong AHC, Hon KL. Breath-Holding Spells in Pediatrics: A Narrative Review of the Current Evidence. Curr Pediatr Rev. 2019;15(1):22-29. doi: 10.2174/1573396314666181113094047

Goraya JS, Virdi VS. Persistence of breath-holding spells into late childhood. J Child Neurol. 2001;16(9):697-698. doi: 10.1177/088307380101600916.

Li H, Liao Y, Han Z, et al. Head-up tilt test provokes dynamic alterations in total peripheral resistance and cardiac output in children with vasovagal syncope. Acta Paediatr. 2018;107(10):1786-1791. doi: 10.1111/apa.14342

Li HX, Gao L, Yuan Y. Advance in the understanding of vasovagal syncope in children and adolescents. World J Pediatr. 2021;17(1):58-62. doi: 10.1007/s12519-020-00367-z

Villafane J, Miller JR, Glickstein J, et al. Loss of Consciousness in the Young Child. Pediatr Cardiol. 2021;42(2):234-254. doi: 10.1007/s00246-020-02498-6

Zavala R, Metais B, Tuckfield L, DelVecchio M, Aronoff S. Pediatric Syncope: A Systematic Review. Pediatr Emerg Care. 2020;36(9):442-445. doi: 10.1097/PEC.0000000000002149

Freeman RD, Soltanifar A, Baer S. Stereotypic movement disorder: easily missed. Dev Med Child Neurol. 2010;52(8):733-738. doi: 10.1111/j.1469-8749.2010.03627.x

Cao L, Huang X, Wang N, et al. Recommendations for the diagnosis and treatment of paroxysmal kinesigenic dyskinesia: an expert consensus in China. Transl Neurodegener. 2021;10(1):7. doi: 10.1186/s40035-021-00231-8

Mink JW. Paroxysmal dyskinesias. Curr Opin Pediatr. 2007;19(6):652-656. doi: 10.1097/MOP.0b013e3282f1d4c8

Jurewicz A. Dyskinezy napadowe. https://podyplomie.pl/neurologia/37067,dyskinezy-napadowe. Accessed September 20, 2023.

McGuire S, Chanchani S, Khurana DS. Paroxysmal Dyskinesias. Semin Pediatr Neurol. 2018;25:75-81. doi: 10.1016/j.spen.2017.12.007

Hao SS, Feng YH, Zhang GB, Wang AP, Wang F, Wang P. Neuropathophysiology of paroxysmal, systemic, and other related movement disorders. Eur Rev Med Pharmacol Sci. 2015;19(13):2452-2460.

Bruno MK, Hallett M, Gwinn-Hardy K, et al. Clinical evaluation of idiopathic paroxysmal kinesigenic dyskinesia: new diagnostic criteria. Neurology. 2004;63(12):2280-2287. doi: 10.1212/01.wnl.0000147298.05983.50

Méneret A, Roze E. Paroxysmal movement disorders: An update. Rev Neurol (Paris). 2016;172(8-9):433-445. doi: 10.1016/j.neurol.2016.07.005

Unterberger I, Trinka E. Diagnosis and treatment of paroxysmal dyskinesias revisited. Ther Adv Neurol Disord. 2008;1(2):4-11. doi: 10.1177/1756285608095119

Spacey S, Adams P. Familial paroxysmal nonkinesigenic dyskinesia. In: GeneReviews(R). Pagon RA, et al, ed. Seattle (WA); 1993.

Bhatia KP. Paroxysmal dyskinesias. Mov Disord. 2011;26(6):1157-1165. doi: 10.1002/mds.23765

Efron D, Dale RC. Tics and Tourette syndrome. J Paediatr Child Health. 2018;54(10):1148-1153. doi: 10.1111/jpc.14165

Set KK, Warner JN. Tourette syndrome in children: An update. Curr Probl Pediatr Adolesc Health Care. 2021;51(7):101032. doi: 10.1016/j.cppeds.2021.101032

Knight T, Steeves T, Day L, Lowerison M, Jette N, Pringsheim T. Prevalence of tic disorders: a systematic review and meta-analysis. Pediatr Neurol. 2012;47(2):77-90. doi: 10.1016/j.pediatrneurol.2012.05.002

Balint B, Thomas R. Hereditary Hyperekplexia Overview. In: Adam MP, Mirzaa GM, Pagon RA, et al., ed. GeneReviews® [Internet]. Seattle: University of Washington; 1993-2023. https://www.ncbi.nlm.nih.gov/books/NBK1260/. Accessed September 20, 2023.

Lee Y, Kim NY, Hong S, et al. Familial Hyperekplexia, a Potential Cause of Cautious Gait: A New Korean Case and a Systematic Review of Phenotypes. J Mov Disord. 2017;10(1):53-58. doi: 10.14802/jmd.16044

Kotagal P, Costa M, Wyllie E, Wolgamuth B. Paroxysmal nonepileptic events in children and adolescents. Pediatrics. 2002;110(4):e46. doi: 10.1542/peds.110.4.e46

D'Adamo MC, Imbrici P, Sponcichetti F, Pessia M. Mutations in the KCNA1 gene associated with episodic ataxia type-1 syndrome impair heteromeric voltage-gated K(+) channel function. FASEB J. 1999;13(11):1335-1345. doi: 10.1096/fasebj.13.11.1335

Choi KD, Choi JH. Episodic Ataxias: Clinical and Genetic Features. J Mov Disord. 2016;9(3):129-135. doi: 10.14802/jmd.16028

Huntsman RJ, Lowry NJ, Sankaran K. Nonepileptic motor phenomena in the neonate. Paediatr Child Health. 2008;13(8):680-684. doi: 10.1093/pch/13.8.680

Facini C, Spagnoli C, Pisani F. Epileptic and non-epileptic paroxysmal motor phenomena in newborns. J Matern Fetal Neonatal Med. 2016;29(22):3652-3659. doi: 10.3109/14767058.2016.1140735

Cross JH. Differential diagnosis of epileptic seizures in infancy including the neonatal period. Semin Fetal Neonatal Med. 2013;18(4):192-195. doi: 10.1016/j.siny.2013.04.003

Youssef PE, Mack KJ. Episodic and chronic migraine in children. Dev Med Child Neurol. 2020;62(1):34-41. doi: 10.1111/dmcn.14338

Greene K, Irwin SL, Gelfand AA. Pediatric Migraine: An Update. Neurol Clin. 2019;37(4):815-833. doi: 10.1016/j.ncl.2019.07.009

Blumenfeld AE, Victorio MC, Berenson FR. Complicated Migraines. Semin Pediatr Neurol. 2016;23(1):18-22. doi: 10.1016/j.spen.2016.01.007

Blom JD. Alice in Wonderland syndrome: A systematic review. Neurol Clin Pract. 2016;6(3):259-270. doi: 10.1212/CPJ.0000000000000251

Perez-Garcia L, Pacheco O, Delgado-Noguera L, Motezuma JPM, Sordillo EM, Paniz Mondolfi AE. Infectious causes of Alice in Wonderland syndrome. J Neurovirol. 2021;27(4):550-556. doi: 10.1007/s13365-021-00988-8

Unterberger I, Trinka E. Diagnosis and treatment of paroxysmal dyskinesias revisited. Ther Adv Neurol Disord. 2008;1(2):4-11. doi: 10.1177/1756285608095119

National Institutes of Health. Tourette Syndrome. https://www.ninds.nih.gov/health-information/disorders/tourette-syndrome. Accessed September 20, 2023.

Al Khalili Y, Asuncion RMD, Chopra P. Migraine Headache in Childhood. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557813/. Accessed September 20, 2023.

Kurlan RM. Treatment of Tourette syndrome. Neurotherapeutics. 2014;11(1):161-165. doi: 10.1007/s13311-013-0215-4.

Bielicka-Cymerman J. Zaburzenia napadowe niepadaczkowe u dzieci. https://padaczka.pl/padaczka/wiecej-informacji/zaburzenia-napadowe-niepadaczkowe-u-dzieci. Accessed July 18, 2023.

Mandli AH, Desai NA, Badheka RS, Udani VP. Paroxysmal Nonepileptic Events in a Pediatric Epilepsy Clinic. J Pediatr Neurosci. 2021;16(1):17-23. doi: 10.4103/jpn.JPN_33_20.

Steinborn B, Malendowicz-Major B. Semiological and psychiatric characteristics of children with psychogenic non-epileptic seizures. Neurol Dziec. 2018;27(55):11-14. doi: 10.20966/chn.2018.55.425

Lossius MI, Villagran A, Karterud HN, Henning O, Nakken KO. Psychogenic non-epileptic seizures in children. Tidsskr Nor Laegeforen. 2016;136(23-24):1993-1995. doi: 10.4045/tidsskr.16.0312

Downloads

Published

2024-03-30

How to Cite

Syzdoł, B., Ziółkiewicz, A., Sielwanowska, W., Żybowska, M., Wilczek, N., Szukała, K., & Chrościńska-Krawczyk, M. (2024). Paroxysmal non-epileptic events vs epilepsy – what we know and where we are in medicine?. European Journal of Clinical and Experimental Medicine, 22(1), 164–171. https://doi.org/10.15584/ejcem.2024.1.1

Issue

Section

REVIEW PAPERS

Most read articles by the same author(s)