Episodic symptoms to be considered in the differential diagnosis of epileptic seizures

Table 12.3-3. Episodic symptoms to be considered in the differential diagnosis of epileptic seizures
General category	Seizure phenomena mimicked	Leading symptom(s)
Neurologic causes
Movement disorders: – Dyskinesias – Episodic ataxia – Myoclonus – Startle reaction as a result of sudden surprise or alarm – Tic – Cataplexy	– Motor seizures – Myoclonic seizures – Reflex seizures	Motor signs
Parasomnias: – NREM disorder – REM disorder – Narcolepsy	– Nocturnal seizures – Negative motor seizure	Sleep phenomena
Other neurologic: – Migraine – TIA – Vertigo – Charles Bonnet syndrome	– Posterior cortex seizure (parieto-occipital)	– Somatosensory – Vertigo – Headache – Visual
Nonneurologic medical causes
Cardiovascular: – Rhythmogenic – Vasovagal – Orthostatic/POTS – Pulmonary embolism – Other (eg, carcinoid)	Seizure with ictal asystole	– Loss of consciousness – Syncope
Metabolic: – Hypoglycemia – Intoxication – Tetany	– Postictal state – Nonconvulsive SE	Coma
(Neuro-)psychiatric causes
Dissociative and other: – Psychogenic nonepileptic seizure – Fugue – Psychosis – Stupor – PTSD – Panic attacks – Transient global amnesia – Organic disease affecting amnestic function – Dementia	– Grand mal SE – Nonconvulsive SE – Amnesic seizure – Affective seizure – Focal SE	– Behavioral symptoms – Altered mental state – Hallucinatory state – Amnestic state
Physiologic phenomena
A variety of normal phenomena could be mistaken for signs of disease, eg, myoclonic jerks that occur with transition to light sleep
NREM, non–rapid eye movement; POTS, postural orthostatic tachycardia syndrome; PTSD, posttraumatic stress disorder; REM, rapid eye movement; SE, status epilepticus; TIA, transient ischemic attack.