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Reproduced with permission from 2 , ness. Sensory seizures that originate in visual cortex or auditory cortex produce visual and auditory hallucinations, respectively. As emphasized in the 1981 classification 2 , epileptic hallucinations vary in sophistication from ill-formed patterns of light and sound to well-structured images and recognizable sounds such as music 2 . Ictal olfactory hallucinations tend to be vague but are generally disagreeable. Hallucinated tastes are frequently metallic....

M Cook

Episodic disorders of consciousness or behaviour are a common cause of visits to emergency departments, family physicians and neurologists. Whilst the diagnosis of an epileptic disorder may be straightforward, it is frequently difficult, especially if the event is unwitnessed, or if the history is incomplete. Among the wide variety of neurological and non-neurological conditions that may be mistaken for epilepsy the most frequent and challenging distinction is between epileptic events and...

Common causes of acute symptomatic seizures

In a study done in a well-defined population, the age-adjusted incidence rate of symptomatic seizures was about 40 per 100000 person-years 11 . The rate was higher in men than in women 52 vs. 29 per 100000 year . The rate was highest in the first year of life during which metabolic, infectious and encephalopathic factors were the predominant aetiologies. The rate decreased in childhood and early adulthood, with a nadir at 25-34 years. Then, the risk tended to increase with age producing a...

Endocrine and metabolic abnormalities

Disturbances of hormones, glucose, fluids and electrolytes can causes seizures, or seizure-like events 76,77 . When occult abnormalities such as insulinomas present with seizures, the diagnosis can be challenging. The most common cause of transiently altered awareness due to endocrine abnormality is hypoglycaemia related to insulin therapy of diabetes. This can cause confusional episodes, generalized tonic-clonic convulsions and sometimes episodes imitating focal seizures. Although...

Vertigo

Vertigo with brief episodes of dysequilibrium is often misinterpreted as seizure activity. This is because many patients describe the episode as involving loss of awareness, though this is not confirmed by witnesses. Whilst vertigo may rarely occur as a feature of focal seizures, especially those originating in frontal or parietal regions 70,71 , other non-specific symptoms, such as light-headedness and dizziness, are more often reported as a feature of convulsive episodes. In vertigo due to...