Q&A: Epilepsy misdiagnosis

A report which found a hospital consultant misdiagnosed a third of child patients as epileptic has said the figure is not unusual.

BBC News Online looks at why the problem exists.

What did the report say?

Hospital bosses looked at 2,000 cases treated by Dr Andrew Holton, a consultant paediatrician with an interest in epilepsy, who worked at Leicester Royal Infirmary.

They found more than 618 - 31% - of his diagnoses were wrong.

But they said that figure was not unusual.

How can there be such a high rate of misdiagnosis?

The National Society for Epilepsy (NSE) says the condition is an extremely complex one to diagnose - there are around 40 types of seizures that epileptics could have.

But there can also be other conditions which could be mistaken for epilepsy, such as night terrors, temper tantrums, febrile convulsions (sometimes due to overheating) or hypoglycaemia (diabetes).

What tests can be carried out to diagnose epilepsy?

What happens to a person during a seizure and their medical history can help doctors diagnose the condition.

But they may carry out certain tests. An electrocardiogram (ECG) checks the electrical rhythm of the heart.

It can help show if someone's symptoms are caused by a brain seizure or by a brief irregularity of the heart's rhythm.

Doctors may also carry out an electroencephalogram (EEG) which shows doctors how the brain is working by recording activity by picking up electrical signals or impulses produced by brain cells.

Brain scans may also be taken.

Blood tests can help exclude other possible causes for the attacks, such as diabetes.

Is the high error rate common?

Experts believe it is. The NSE estimates a quarter of the patients it sees at its own centre, where patients are referred by hospital specialists have been misdiagnosed as epileptic.

Is it something patients should simply accept?

A spokeswoman for the campaign group Epilepsy Action said: "We don't feel this misdiagnosis rate is acceptable

"Epilepsy is a difficult condition to diagnose, but we should not accept this level of error."

What consequences could misdiagnosis have for children?

Very strong medication is given to treat epilepsy.

Margaret Thomas, of the NSE, said: "The medication could have a very serious effect on memory and concentration.

"Children can then get into a cycle of not achieving as well at school.

"There is also a huge stigma associated with diagnosis."

How many children could be affected?

There are an estimated 60,000 children with epilepsy.

Epilepsy Action said, if Dr Holton's error rate was an indication of the situation in other hospitals, up to 20,000 children could have been wrongly diagnosed and not receiving the treatment they need.

What could improve the situation?

Campaigners say more specialists are needed.

The spokeswoman for the NSE said: "Anybody that has been potentially diagnosed with epilepsy should have that diagnosis made by someone with a specialist interest in epilepsy."

There is a shortage of neurologists in the UK, with just five per million.

Germany has 12 per million, France 15, Spain 23 per million and Italy 71 per million.

Experts say there is also a lack of knowledge about epilepsy at primary care level