Paroxysmal Symptoms: Patient-reported Differences Between Seizure and Migraines
Abstract number :
2.113
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2022
Submission ID :
2204141
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Ellen Snyder, MD – University of Colorado; Saori Haigo, MD – University of Colorado; Michelle Sandoval, Research Services Professional – University of Colorado; Kelly Knupp, MD – Children's Hospital Colorado; Jacob Pellinen, MD – University of Colorado
Rationale: Patients who experience first-time seizures often present to non-specialists in emergency departments or primary care settings. Determining if events are epileptic can be challenging and lead to significant delays in diagnosis. Standardized and evidence-based approaches to history taking, may reduce lag time to diagnosis. We previously created a “Seizure Screen” questionnaire, a simple tool for non-specialists to more easily differentiate epileptic seizures from mimics. In this study, we tested the questionnaire in people with a known diagnosis of epilepsy as well as in those with a known diagnosis of migraines in order to compare responses between people with known diagnoses of epilepsy and an alternative a non-seizure paroxysmal neurologic disorder.
Methods: We recruited 85 patients through our institution’s neurology clinics who had established diagnoses of focal epilepsy (n = 35) and migraines (n = 50). Patients filled out the seizure screening questionnaire online via secure automated REDCap survey, answering the Seizure Screen questions based on their diagnosis. The questionnaire included eight yes-or-no questions on the presence of various event characteristics, and responses were compared using Fisher’s exact test.
Results: Respondents reported their habitual symptoms were sudden-onset in 94% of patients with epilepsy vs. 72% in patients with migraine (p < 0.01). Events involved short lasting symptoms (< 3 minutes) in 77% with epilepsy vs. 8% with migraine (p < 0.01), and long lasting (> 30 minutes) in 17% with epilepsy vs. 98% with migraine (p < 0.01). Respondents considered their symptoms strange-or difficult to describe in 57% with epilepsy vs. 42% with migraine (p = 0.07), and highly-stereotyped 57% of patients with epilepsy vs. 24% in migraine (p < 0.01). Events were described as unprovoked in 66% with epilepsy vs 86% with migraines (p = 0.02), provoked by standing in 17% with epilepsy vs. 0% with migraines (p < 0.01), and followed by fatigue in 83% with epilepsy vs. 92% with migraines (p = 0.12).
Clinical Epilepsy