Misdiagnosis of complex absence seizures

Video-EEG monitoring disclosed absence seizures in five patients who were treated for partial seizures. Analysis of the historical and video data showed the presence of several potentially misleading ictal manifestations as follows: unidirectional head and/or eye turning, symmetric clonic activity, urinary incontinence, loss of balance causing injuries, focal clonic activity, and de novo automatisms. Without EEG correlation, complex absence seizures may be difficult to differentiate from other types of seizures. When correctly diagnosed, appropriate therapy may improve seizure control.