Ab. Ettinger et al., Postictal symptoms help distinguish patients with epileptic seizures from those with non-epileptic seizures, SEIZURE-E J, 8(3), 1999, pp. 149-151
The aim of the study was to assess whether post-ictal symptoms can help dis
tinguish patients who have epileptic seizures from those with non-epileptic
seizures (NES). We reviewed the spontaneous responses to the question 'Wha
t symptoms do you have after a seizure?' in 16 patients with epileptic seiz
ures (predominantly focal with secondary generalization or generalized toni
c-clonic) and 23 NES patients. Six of the 16 patients (38%) vs, only one of
23 NES patients (4.3%) noted post-ictal headache (P = 0.008). Nine epileps
y patients (56%) vs, three NES patients (13%) reported post-ictal fatigue (
P = 0.004). Confusion or other symptoms did not distinguish epilepsy patien
ts from those with NES. All epilepsy patients had at least one post-ictal s
ymptom while 12 NES patients (52%) had none (P = 0.001). Therefore, patient
s evaluated for epileptic vs. non-epileptic seizures who have post-ictal fa
tigue or headache, are more likely to have epileptic seizures. Patients wit
h a diagnosis of NES who note post-ictal fatigue or headache should be inve
stigated further.