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Reenactment of the triggering situation for the diagnosis of epilepsy

Department of Neurologv, Jefferson Medical College, Philadelphia, the VA Central Gffice, Washington, DC, and the Division of Pediatric Neurology and Department of Radiology, University of Wisconsin, Clinical Science Center, Madison, WI.

When a fixed set of ambient circumstances is associated with convulsive or nonconvulsive paroxysmal attacks, reenactment of the situation should be considered as a possible shortcut for reaching a diagnosis. Reenactment determined the diagnosis in 30 of 32 patients with paroxysmal disorders. The referral diagnosis was correct in only 13 of the 32 patients. To be appropriately executed, the reenactment should entail polygraphic recording of at least EEG, ECG, and respiration. Vertex electrodes should be included to avoid overlooking of cortical electrodecremental event. If unsuccessful at the first attempt, reenactment should be repeated.

Address correspondence and reprint requests to Dr. Fariello, Department of Neurology, Jefferson Medical College, Philadelphia, PA 19107.

Presented in part at the annual meeting of the American Epilepsy Society, San Diego, 1980.

Accepted for publication November 16, 1982.