Diagnosed with seizures-Negative EEG

[LovebugLPN]

I saw a patient in her early 30s who was under observation for frequent falls and periods of "blacking out". She had many tests including an EEG, MRI with dye, CT Scan with dye, and labs. All came back negative and she was sent home with no real diagnosis. Another EEG was performed (24 hour) and also came back negative. She was still diagnosed with seizures and will lose her driving license for many months. I thought that a diagnosis of seizures was only possible with positive documentation after an EEG. Has anyone else ever heard of this happening? I am just extemely curious to hear from anyone else about this. Going by symptoms and signs these definetely sound like seizures due to the fact that she has reported having them since she was young and having a "feeling" before one happens. If you went by symptoms only everyone (doctors included) thought these were seizures but again no proof besides.

[aeauooo]

Going by symptoms and signs these definetely sound like seizures due to the fact that she has reported having them since she was young and having a "feeling" before one happens.

Funny you should ask. I just attended a lecture on 'non-epileptic seizures' at the annual meeting of the AANN.

Non-epileptic seizure (we used to call them 'pseudo-seizures') are not seizures at all - they are either psychiatric or behavioral. Some people honestly do not know that they are not having seizures, and are genuinely upset to find out they do not have a seizure disorder, but need psychiatric help instead.

There are some tell-tale signs, but I'm not going to go into it here. (I've seen very bizarre seizures that other nurses thought were pseudo-seizures, and I've also been fooled by malingering patients)

The bottom line is that for the diagnosis to be made, whether she is having seizures and what type, or whether she is having non-epileptic seizures, she needs to be on a monitored epilepsy unit.

[LovebugLPN]

The doctor was positive that if they were not seizures then they are atypical migraines. Either way her license is gone until the medication can control them. It is definetely not psych related.

[topgungirl27]

Hmmmm...very interesting. I just went to the DMV to renew my license and had an indepth conversation with the employee about my shaved head...of course, I told him I just had a craniotomy and nothing else was asked on my paperwork to renew my license. Only thing unusual was that the app. asked if I had an identical twin this time...which I do..lol. Question though...since having my craniotomy over 3 months ago, I have just suffered my first seizure and am wondering what happens to my driving status now. The nurse in the ER told me it'd be 6 months before I could drive again? I did not have the seizure while driving, I had it at home while i was sleeping...whose responsibility is it to report a patients seizure activity to the state or insurance companies?

[LovebugLPN]

Doctors are required by law to report seizures