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Critical Appraisal Topic

Critical Appraisal Topic. Is tongbeet onderscheidend bij epileptisch insult versus syncope?. P patient I interventie C comparison O outcome. Tongbeet epilepsie - syncope. syncope of epileptisch insult. tongbeet. Tongbeet epilepsie - syncope. Zoekstrategie

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Critical Appraisal Topic

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  1. Critical Appraisal Topic Is tongbeet onderscheidend bij epileptisch insult versus syncope?

  2. P patient I interventie C comparison O outcome Tongbeet epilepsie - syncope • syncope of epileptisch insult • tongbeet

  3. Tongbeet epilepsie - syncope Zoekstrategie • 'tongue bite‘ OR "tongue bite“ OR "Tongue/injuries"[MeSH] OR tongue bite 628 • "Epilepsy/diagnosis"[MeSH] 16702 • "Syncope/diagnosis"[MeSH] 1516 • #1 and #2 9 • #1 and #3 1

  4. Tongbeet epilepsie - syncope Arch Intern Med. 1995 Nov 27;155(21):2346-9 Value of tongue biting in the diagnosis of seizures Benbadis SR, Wolgamuth BR, Goren H, Brener S, Fouad-Tarazi FDepartment of Neurology, Cleveland (Ohio) Clinic Foundation, USA • Prospective study of the presence of oral lacerations • 106 consecutive patients admitted to Epilepsy Monitoring Unit • Retrospective study of 45 patients with syncope

  5. Tongbeet epilepsie - syncope Prospectief • Epilepsie video monitoring unit • Achtereenvolgende patienten • Bilaterale motorische verschijnselen • Bewustzijnsverlies of allebei • Tongbeet bij onderzoek • Diagnose: wel of geen epileptische insulten Benbadis et al. Value of tongue biting in the diagnosis of seizures. Arch Intern Med 1995:155:2346-9

  6. Tongbeet epilepsie - syncope Retrospectief • 82 patienten, zelfde periode, met duidelijke diagnose syncope. Poliklinisch. • A / 1 of meerdere episoden compleet bewustzijnsverlies. Wel of geen tongbeet. • O / ECG, Holter, tilt table, autonome functies Benbadis et al. Value of tongue biting in the diagnosis of seizures. Arch Intern Med 1995:155:2346-9

  7. Tongbeet epilepsie - syncope • Results • 106 monitored patients • 63 bilateral motor activity, complete loss conscioussness, both • 34 epileptic seizures • 29 exclusively nonepileptic episodes. Benbadis et al. Value of tongue biting in the diagnosis of seizures. Arch Intern Med 1995:155:2346-9

  8. Tongbeet epilepsie - syncope

  9. Tongbeet epilepsie - syncope Benbadis et al. Value of tongue biting in the diagnosis of seizures. Arch Intern Med 1995:155:2346-9

  10. Tongbeet epilepsie - syncope • Sensitiviteit voor TC insulten: 24% • Specificiteit vs pseudoepilepsie: 99% • Specificiteit vs alle niet epileptische aaanvallen: 100% • Als alleen laterale tongbeet wordt meegenomen: • 100% specificiteit

  11. Tongbeet epilepsie - syncope • Kritiek • Prospectief en retrospectief • Kleine getallen • 100% specificiteit (95% BI 97 tot 100) • Geselecteerde populaties, verschillend • Aanwezigheid tongbeet beïnvloedt diagnose epilepsie

  12. Tongbeet epilepsie - syncope • Conclusie • Laterale tongbeet matig sensitief • Waarschijnlijk zeer specifiek voor gegeneraliseerde tonisch clonische insulten De Krom had gelijk

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