Misdiagnosis and pitfalls in Panayiotopoulos syndrome

Alessandro Graziosi, Noemi Pellegrino, Vincenzo Di Stefano, Umberto Raucci, Anna Luchetti, Pasquale Parisi

Research output: Contribution to journalReview article

Abstract

Panayiotopoulos syndrome (PS) is a frequent (6% among children of 1-15 years) and benign epileptic syndrome, characterized by predominantly autonomic symptoms (emesis, pallor, flushing, cyanosis, mydriasis/miosis, cardiorespiratory and thermoregulatory alterations, incontinence of urine and/or feces, hypersalivation, and modifications of intestinal motility) associated with simple motor focal seizures, which can be followed by secondary generalization. Panayiotopoulos syndrome can be extremely insidious, because it can mimic several condition, such as gastroenteritis, gastroesophageal reflux disease, encephalitis, syncope, migraine, sleep disorders, or even metabolic diseases. This peculiar pleiotropism should be kept in mind by child neurologists and pediatricians and general practitioners, because a wrong diagnosis may lead to inappropriate interventions. The consequences are high morbidity, costly mismanagement, and stress for children and their parents. The availability of electroencephalography (EEG) recording in pediatric Emergency Departments might be useful for a prompt and not-cost-consuming diagnosis. On the other hand, it is important to be aware of the possible, multifaceted, clinical presentations of PS and its clinical, radiological, and neurophysiological features in order to improve both recognition and management.

Original languageEnglish
Pages (from-to)124-128
Number of pages5
JournalEpilepsy and Behavior
Volume98
Issue numberPt A
DOIs
Publication statusPublished - Sep 2019

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Diagnostic Errors
Seizures
Sialorrhea
Miosis
Mydriasis
Pallor
Cyanosis
Gastrointestinal Motility
Metabolic Diseases
Gastroenteritis
Syncope
Encephalitis
Gastroesophageal Reflux
Migraine Disorders
Feces
General Practitioners
Vomiting
Hospital Emergency Service
Electroencephalography
Parents

Cite this

Graziosi, A., Pellegrino, N., Di Stefano, V., Raucci, U., Luchetti, A., & Parisi, P. (2019). Misdiagnosis and pitfalls in Panayiotopoulos syndrome. Epilepsy and Behavior, 98(Pt A), 124-128. https://doi.org/10.1016/j.yebeh.2019.07.016

Misdiagnosis and pitfalls in Panayiotopoulos syndrome. / Graziosi, Alessandro; Pellegrino, Noemi; Di Stefano, Vincenzo; Raucci, Umberto; Luchetti, Anna; Parisi, Pasquale.

In: Epilepsy and Behavior, Vol. 98, No. Pt A, 09.2019, p. 124-128.

Research output: Contribution to journalReview article

Graziosi, A, Pellegrino, N, Di Stefano, V, Raucci, U, Luchetti, A & Parisi, P 2019, 'Misdiagnosis and pitfalls in Panayiotopoulos syndrome', Epilepsy and Behavior, vol. 98, no. Pt A, pp. 124-128. https://doi.org/10.1016/j.yebeh.2019.07.016
Graziosi A, Pellegrino N, Di Stefano V, Raucci U, Luchetti A, Parisi P. Misdiagnosis and pitfalls in Panayiotopoulos syndrome. Epilepsy and Behavior. 2019 Sep;98(Pt A):124-128. https://doi.org/10.1016/j.yebeh.2019.07.016
Graziosi, Alessandro ; Pellegrino, Noemi ; Di Stefano, Vincenzo ; Raucci, Umberto ; Luchetti, Anna ; Parisi, Pasquale. / Misdiagnosis and pitfalls in Panayiotopoulos syndrome. In: Epilepsy and Behavior. 2019 ; Vol. 98, No. Pt A. pp. 124-128.
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N2 - Panayiotopoulos syndrome (PS) is a frequent (6% among children of 1-15 years) and benign epileptic syndrome, characterized by predominantly autonomic symptoms (emesis, pallor, flushing, cyanosis, mydriasis/miosis, cardiorespiratory and thermoregulatory alterations, incontinence of urine and/or feces, hypersalivation, and modifications of intestinal motility) associated with simple motor focal seizures, which can be followed by secondary generalization. Panayiotopoulos syndrome can be extremely insidious, because it can mimic several condition, such as gastroenteritis, gastroesophageal reflux disease, encephalitis, syncope, migraine, sleep disorders, or even metabolic diseases. This peculiar pleiotropism should be kept in mind by child neurologists and pediatricians and general practitioners, because a wrong diagnosis may lead to inappropriate interventions. The consequences are high morbidity, costly mismanagement, and stress for children and their parents. The availability of electroencephalography (EEG) recording in pediatric Emergency Departments might be useful for a prompt and not-cost-consuming diagnosis. On the other hand, it is important to be aware of the possible, multifaceted, clinical presentations of PS and its clinical, radiological, and neurophysiological features in order to improve both recognition and management.

AB - Panayiotopoulos syndrome (PS) is a frequent (6% among children of 1-15 years) and benign epileptic syndrome, characterized by predominantly autonomic symptoms (emesis, pallor, flushing, cyanosis, mydriasis/miosis, cardiorespiratory and thermoregulatory alterations, incontinence of urine and/or feces, hypersalivation, and modifications of intestinal motility) associated with simple motor focal seizures, which can be followed by secondary generalization. Panayiotopoulos syndrome can be extremely insidious, because it can mimic several condition, such as gastroenteritis, gastroesophageal reflux disease, encephalitis, syncope, migraine, sleep disorders, or even metabolic diseases. This peculiar pleiotropism should be kept in mind by child neurologists and pediatricians and general practitioners, because a wrong diagnosis may lead to inappropriate interventions. The consequences are high morbidity, costly mismanagement, and stress for children and their parents. The availability of electroencephalography (EEG) recording in pediatric Emergency Departments might be useful for a prompt and not-cost-consuming diagnosis. On the other hand, it is important to be aware of the possible, multifaceted, clinical presentations of PS and its clinical, radiological, and neurophysiological features in order to improve both recognition and management.

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