title: Postictal symptoms help distinguish patients with epileptic seizures from those with non-epileptic seizures.
abstract: The aim of the study was to assess whether post-ictal symptoms can help distinguish patients who have epileptic seizures from those with non-epileptic seizures (NES). We reviewed the spontaneous responses to the question 'What symptoms do you have after a seizure?' in 16 patients with epileptic seizures (predominantly focal with secondary generalization or generalized tonic-clonic) and 23 NES patients. Six of the 16 patients (38%) vs. only one of 23 NES patients (4.3%) noted post-ictal headache (P = 0.008). Nine epilepsy patients (56%) vs. three NES patients (13%) reported post-ictal fatigue (P = 0.004). Confusion or other symptoms did not distinguish epilepsy patients from those with NES. All epilepsy patients had at least one post-ictal symptom while 12 NES patients (52%) had none (P = 0.001). Therefore, patients evaluated for epileptic vs. non-epileptic seizures who have post-ictal fatigue or headache, are more likely to have epileptic seizures. Patients with a diagnosis of NES who note post-ictal fatigue or headache should be investigated further.
authors.affiliation: Department of Neurology, Division of Child and Adolescent Psychiatry and the Epilepsy Management Program, State University of New York at Stony Brook, Stony Brook, NY 11794, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Ettinger
authors.forename: D M
authors.initials: DM
authors.lastname: Weisbrot
authors.forename: E
authors.initials: E
authors.lastname: Nolan
authors.forename: O
authors.initials: O
authors.lastname: Devinsky
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D003221:Confusion / Q000209:etiology; D003937:Diagnosis, Differential; D004828:Epilepsies, Partial / Q000150:complications / Q000175:diagnosis*; D004830:Epilepsy, Tonic-Clonic / Q000150:complications / Q000175:diagnosis*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011602:Psychophysiologic Disorders / Q000150:complications / Q000175:diagnosis*; D012640:Seizures / Q000209:etiology*