BIOGRAPHY
Philip Parkin is a full-time consultant neurologist at Christchurch. He was Clinical Director of the department of Neurology for nearly two decades and has been active in a number of national neurological organisations over many years, including a 20-year term as Councillor of the New Zealand Neurological Foundation and a member of its Scientific Advisory Committee. His interests cover the breadth of Clinical Neurology and Clinical Neurophysiology. ABSTRACT Is It Really Epilepsy?
Because it is the most common primary disorder affecting the brain, it is hardly surprising that epilepsy is the diagnostic possibility so frequently considered whenever a patient presents having undergone a blackout or other transient neurological event. While it is a diagnosis easily made in many patients, family practice-based studies in the UK have suggested that in up to a quarter of those believed to have epilepsy the diagnosis, in fact, proved to be incorrect. Of the wide array of disorders that can be mistaken for epilepsy two, in particular, account for the majority or epilepsy mis-diagnoses. This review of how to diagnose epilepsy will therefore focus, in particular, on how to avoid being misled by these two epilepsy look-alikes.
MRI and the general physician: ‘New’ disorders defined by MRI
For this review I have chosen five different neurologic disorders to discuss. Although, as a group, they are responsible for a diverse range of clinical symptoms, each one of them can potentially present as the acute thunderclap headache syndrome.
In each one of them, a CT brain scan is often normal. While a standard MRI brain scan may be normal, too, a more specifically targeted MRI scan will usually establish the diagnosis.
As experience has been gained, each one of these disorders has turned out to be much more common, and their pattern of clinical presentation more diverse, than was ever previously recognised.
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