Pediatric epilepsies misdiagnosed as gastrointestinal disorders
Giulia Carbonari1, Giacomo Tonti1, Veronica Di Pisa2
1Pediatric Department, S. Orsola Hospital in Bologna, University of Bologna, Italy.
Insights
Pediatric epilepsy is often misdiagnosed as gastrointestinal (GI) disorders, leading to delayed diagnosis and treatment. Early consideration of epilepsy in infants with atypical reflux symptoms is crucial for better outcomes.
Area of Science:
- Pediatric Neurology
- Gastroenterology
Background:
- Several pediatric epilepsy cases are misdiagnosed as gastrointestinal (GI) disorders.
- This misdiagnosis can lead to delayed treatment and adverse prognostic consequences.
Purpose of the Study:
- To determine the frequency and characteristics of misdiagnosed pediatric epilepsy cases.
- To evaluate the impact of misdiagnosis on diagnostic delay.
Main Methods:
- Retrospective analysis of 858 pediatric epilepsy patients diagnosed between 2010 and 2015.
- Identification of patients with a prior misdiagnosis of a GI disorder.
Main Results:
- 2.4% of patients (21/858) were initially misdiagnosed with a GI disorder.
- Common epilepsy syndromes included West syndrome, temporal lobe epilepsy, and Panayiotopoulos syndrome.
- Median diagnostic delay was 15.5 months, with younger children (<1 year) being the majority affected.
Conclusions:
- Epilepsy is frequently misdiagnosed as GI disorders in children, particularly in infants.
- Gastroesophageal reflux disease was the most common misdiagnosis.
- Epilepsy should be considered in the differential diagnosis of atypical GI symptoms in children to prevent treatment delays.
Abstract:
In the last years, several cases of pediatric epilepsies misdiagnosed and treated as gastrointestinal (GI) disorders have been reported. The aim of this study was to evaluate both frequency and characteristics of these erroneous diagnoses. We identified children who had received a previous misdiagnosis of GI disorder out of 858 consecutive patients with a diagnosis of epilepsy at our hospital from 2010 to 2015. Misdiagnosis was observed in 21 patients (2.4%): 7 children with West syndrome, 10 with temporal lobe epilepsy, and 4 with Panayiotopoulos syndrome. The majority of children with a misdiagnosis (12/21) were younger than 1year at epilepsy onset, and median diagnostic delay was 15.5months. The most frequently diagnosed GI disorder was gastroesophageal reflux disease, especially in younger children. The study confirms that epilepsy in a significant percentage of children is wrongly identified and treated as GI disorders. In particular, epilepsy should be considered in the differential diagnosis of "atypical" gastroesophageal reflux in younger children in order to avoid serious prognostic consequences.
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