Epilepsy in the UK: Misdiagnosis, mistreatment, and undertreatment?

Abstract

Approximately 55% of the population of adults receiving treatment for epilepsy have never received specialist advice. Reassessment of these patients uncovers diagnostic uncertainty, failure to classify (leading to sub-optimal therapy) and lack of information and advice about all aspects of epilepsy care. The development of integrated services for people with epilepsy (PWE) must take account of this hidden need. The new General Medical Services contract for general practitioners will bring this need to our attention, and our experience will help predict the measures required to deal with the under-treatent and mistreatment of this group. The majority of PWE, not currently receiving shared care, merit reassessment and approximately one-third will require continued specialist care. Existing services do not have the capacity to process a marked increase in rate of referral. This project informs prioritisation of referrals and service reorganisation.

Prevalence and neuro-psychiatric comorbidities of pediatric epilepsy in Taiwan: A national population-based study

“…Urban-rural health-care disparities in Taiwan are apparently (Lin et al, 2007;Lin et al, 2013;Wang et al, 2013). Study proved neurologists are better at diagnosing epilepsy than non-specialists with misdiagnosis rate 5.6% versus 18.9% (Leach et al, 2005). Pediatric epilepsy and related neuropsychological comorbidities are majorly diagnosed and treated by pediatric neurologists and pediatric psychiatrists in Taiwan.…”

Misdiagnosis in epilepsy: a review and recognition of diagnostic uncertainty

“…In a subsequent study, ‘the Wrexham area epilepsy project’ conducted by Leach et al. [4], 275 patients with a diagnosis of epilepsy were reviewed in a specialist epilepsy clinic and categorized independently by specialist registrar and epilepsy consultant as diagnosis secure or diagnosis doubtful. The latter occurred if there was an alternate explanation for the attacks or insufficient evidence for a confident diagnosis of epilepsy.…”

The role of companions in outpatient seizure clinic interactions: A pilot study

“…However, patients with seizures are routinely invited to bring along a companion when they attend outpatient appointments. National guidelines and studies focusing on the risk of misdiagnosis underline the importance of obtaining descriptions not only from patients but also from witnesses of attacks [11][12][13][14].…”