Misdiagnosis of gastroesophageal reflux disease as epileptic seizures in children

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• 作者：Ayşe Kaç ; ar Bayram^a ; ^{draysebayram@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Mehmet Canpolat^a ; ^{drmehmetcanpolat@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Neslihan Karacabey^b ; ^{dr.neslihan@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Hakan Gumus^a ; ^{hakgumus33@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Sefer Kumandas^a ; ^{skumandas@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Selim Doğanay^c ; ^{selimdoganay@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Duran Arslan^b ; ^{duran@erciyes.edu.tr" class="auth_mail" title="E-mail the corresponding author} ; Hü ; seyin Per^a ; ^{huseyinper@yahoo.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Children ; Epileptic seizure ; Gastroesophageal reflux disease ; Misdiagnosis ; Paroxysmal nonepileptic events
• 刊名：Brain and Development
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：38
• 期：3
• 页码：274-279
• 全文大小：332 K

文摘

Gastroesophageal reflux disease (GERD) can mimic epileptic seizure, and may be misdiagnosed as epilepsy. On the other hand, GERD can be more commonly seen in children with neurological disorders such as cerebral palsy (CP); this co-incidence may complicate the management of patients by mimicking refractory seizures.

Objective

The purpose of our study was to evaluate the clinical features, definite diagnoses and treatment approaches of the patients with clinically suspected GERD who were referred to the division of pediatric neurology with a suspected diagnosis of epileptic seizure. We also aimed to investigate the occurrence of GERD in children with epilepsy and/or CP.

Methods

Fifty-seven children who had a final diagnosis of GERD but were initially suspected of having epileptic seizures were assessed prospectively.

Results

All patients were assigned to 3 groups according to definite diagnoses as follows: patients with only GERD who were misdiagnosed as having epileptic seizure (group 1: n = 16; 28.1%), those with comorbidity of epilepsy and GERD (group 2: n = 21; 36.8%), and those with the coexistence of GERD with epilepsy and CP (group 3: n = 20; 35.1%). Five patients (8.8%) did not respond to anti-reflux treatment and laparoscopic reflux surgery was performed. The positive effect of GERD therapy on paroxysmal nonepileptic events was observed in 51/57 (89.5%) patients.

Conclusions

GERD is one of the important causes of paroxysmal nonepileptic events. In addition, GERD must be kept in mind at the initial diagnosis and also in the long-term management of patients with neurological disorders such as epilepsy and CP.