DIFFERENTIAL DIAGNOSIS OF PAROXYSMAL STATES: LITERATURE REVIEW AND ANALYSIS OF A CLINICAL CASE ON THE EXAMPLEOF CLOCCS-SYNDROME IN A YOUNG MAN

Wiad Lek. 2022;75(4 pt 1):907-913. doi: 10.36740/WLek202204127.

Abstract

Diagnosis of paroxysmal conditions in neurology is one of the most difficult problems. Particular difficulties are caused by differential diagnosis of epileptic and non-epileptic paroxysmal states. There are no absolutely pathognomonic signs of epileptic and non-epileptic seizures. False positive diagnosis of epilepsy occurs in 2-71% of cases. Diagnosis of paroxysmal conditions requires an integrated approach to the problem and includes not only a clinical examination, but also a thorough history taking, neurophysiological, neuroimaging, laboratory research methods, involves the involvement of other specialists. The article presents a clinical case of 27-year-old young man who was initially misdiagnosed. Using the methods of functional and laboratory diagnostics, the patient was diagnosed correctly. Instead of idiopathic epilepsy, he was diagnosed with cytotoxic lesions of the corpus callosum (CLOCCs-syndrome associated with an infectious process) with motor paroxysms of non-epileptic genesis. Thus, using the example of this clinical case, it has been shown that the differential diagnosis of epileptic and non-epileptic paroxysmal states presents significant difficulties for a practicing neurologist.

Keywords: CLOCCs-syndrome; Epstein-Barr virus; diagnostic; epilepsy; non-epileptic states.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Electroencephalography*
  • Epilepsy* / diagnosis
  • Humans
  • Male
  • Seizures / diagnosis
  • Syndrome