This is one more article on cardiac disorders being easily misdiagnosed as epilepsy. This is a press release from the American College of Cardiology:
ACC News Releases
Contact:
media@acc.org
Seizure-Like Attacks May Mean Cardiovascular Problems, Not Epilepsy
(July 1, 2000)--Physicians have long suspected that many patients being treated for epilepsy aren't actually suffering from the disease. Now a new study published in the July 2000 issue of the Journal of the American College of Cardiology reveals that the rate of misdiagnosis may be more than 40 percent.
"Two out of five patients in our study had been told that their blackouts were caused by epilepsy, and many were taking powerful drugs to treat the condition--with little if any benefit," explained lead author Dr. Amir Zaidi, of the Manchester Heart Centre at the Royal Infirmary in Manchester, England. "In reality, these patients had heart or circulation problems that could be effectively treated with cardiac drugs or pacemakers."
The study was born when local neurologists began sending Dr. Zaidi epilepsy patients who had uncertain diagnoses or who had failed to respond to anticonvulsant medication. In the resulting study, Dr. Zaidi and his colleagues put 74 of these patients through simple cardiovascular tests--head-up tilt tests and carotid sinus massage--to see if their problems were really cardiovascular in nature. In the head-up tilt test, patients are strapped to a table and slowly tilted until they are nearly vertical; blood pooling in the legs reduces blood flow to the heart and causes fainting in susceptible individuals. In carotid sinus massage, pressing on the carotid artery in the neck slows the heart down and causes fainting in susceptible individuals.
What Dr. Zaidi and his research team found surprised them. Almost 42 percent of the patients had been incorrectly diagnosed with epilepsy. Instead, many suffered from a severe form of fainting called vasovagal syncope.
"We were taken aback by the level of misdiagnosis, which was at least twice as high as expected," said Dr. Zaidi, noting that other studies have suggested misdiagnosis rates of only 20 percent. "The most important message of our study is that if a patient with seizure-like attacks thought to be caused by epilepsy does not respond to treatment, the physician should reconsider the diagnosis."
For Dr. Melvin M. Scheinman, of the University of California, San Francisco, the study's value lies in its discovery of just how common the misdiagnosis of epilepsy is.
"It has long been appreciated that apparent 'epileptic fits' may have a cardiac cause," said Dr. Scheinman. "The importance of Dr. Zaidi's study is to highlight the frequency of this association."
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http://www.acc.org/media/releases/highlights/2000/july00/seizure.htm
It may be just as easy to misdiagnose someone with magnesium deficiency with syncope as epilepsy. The point to make here is we need to keep our radar up and not lock ourselves into conclusions. 70% of the time the cause of seizures in those labeled with epilepsy is not known. It is up to those of us who have seizure disorders to be vigilant about looking at and addressing possible causes.
All the massive publicity about syncope goes hand in hand with the introduction and marketing of a treatment, a defibrillator. The same type of "awareness campaigns" are waged when new epilepsy drugs are introduced as well. It is called "Branding a condition" a marketing strategy used to create a market for drugs and other products. The strategy is to "raise awareness" about a condition, like epilepsy while also pairing this information with what seems to be the one and only solution, the drug being marketed, or insertable loops for syncope, VNS, for seizures.
It is right out of propaganda 101, an doctors are the prime target as they as so good at selling the products. We do well to keep our feet on the ground and look at issues, but not get caught up into buying into anything hook line and sinker. Seizures are as unique as the person who has them. Each treatment plan needs to be individualized.
