Evaluation of Preschool Children with the Diagnosis of Non-epileptic Paroxysmal Disorders in a Pediatric Neurology Outpatient Clinic

Abstract

Objective: Recurrent non-epileptic disorders that differ according to age play an important role in the differential diagnosis of childhood epilepsy. The aim of this study was to evaluate preschool children with recurrent non-epileptic paroxysmal disorders who were admitted to a pediatric neurology outpatient clinic. Methods: Seventy-five children younger than 6 years of age who were admitted to a pediatric neurology outpatient clinic between January 2017 and January 2018 due to recurrent non-epileptic disorders were included in the study. The number of patients presenting with seizures and all other diagnoses were also recorded. Descriptive statistical analyses and chi-square test were used as statistical methods. Results: Of the patients, 36 were female (48%) and 39 (52%) were male. The mean age was 22.5±17.2 months, with the youngest patient being 2 months and the oldest patient being 69 months old. Sixteen different diagnoses were detected. The prevalance of the disorder among 1575 new patients was 4.7%. The two most common diagnoses were breath-holding spells and gratification disorder. Of all patients, 29 patients (39%) had breath-holding spells and 46 (61%) had other diagnoses. Episode during examination happened most commonly in tic disorders, and least commonly in breath-holding spells and gratification disorder. The need for home video recording for diagnosis was mostly in patients with gratification disorder. Episode during examination, and need for video recording, sleep electroencephalography and cranial magnetic resonance imaging were significantly lower in breath-holding spells compared with other diagnoses (p<0.05). Children with the diagnoses of breathholding spells was prescribed and used more iron formulations and piracetam than the patients with other non-epileptic paroxysmal disorders (p<0.05). Conclusion: Home video recordings can prevent a misdiagnosis of epilepsy in patients with recurrent non-epileptic paroxysmal disorders. Accurate and timely diagnosis is possible without the need for further examination with medical history only in cases where the clinical symptoms are stereotypic.