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Value of tongue biting in the differential diagnosis between epileptic seizures and syncope
Brigo, F; Nardone, R; Bongiovanni, LG
SEIZURE-EUR J EPILEP. 2012; 21(8): 568-572.
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PMU-Autor/inn/en

Nardone Raffaele

Abstract

Background: Tongue biting (TB) may occur both in epileptic seizures and in syncope. A comprehensive search of the literature to determine the accuracy of this physical finding and its prevalence in epileptic seizures and syncope is still lacking. Aims: To undertake a systematic review and a meta-analysis of studies evaluating the prevalence of TB in patients with epileptic seizures and syncope, and to determine sensitivity, specificity and likelihood ratios (LR) of this physical finding. Method: Studies comparing the prevalence of TB in epileptic seizures and syncope were systematically searched. Prevalence of TB was analyzed calculating odds ratio (OR) with 95% confidence intervals (CIs). Sensitivity, specificity, positive and negative likelihood ratio (pLR, nLR) of TB were determined for each study and for the pooled results. Results: Two studies (75 epilepsy patients and 98 subjects with syncope) were included. There was a significantly higher prevalence of TB in patients with epileptic seizures (OR 12.26; 95% CI 3.99-37.69). Pooled accuracy measures of TB for the diagnosis of epileptic seizures were: sensitivity 33%, specificity 96%, pLR 8.167 (95% CI 2.969-22.461) and nLR 0.695 (95% CI 0.589-0.82). Conclusions: A pooled analysis of data from the literature shows that TB has great value in the differential diagnosis between epileptic seizures and syncope. Given a certain pre-test probability of seizures, the presence of TB greatly increases the chance that the patient had an epileptic seizure. Systematic reviews with pooled analyses (meta-analyses) of data from the literature allow an increase in statistical power and an improvement in precision, representing a useful tool to determine the accuracy of a certain physical finding in the differential diagnosis between seizures and other paroxysmal events. (C) 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.


Useful keywords (using NLM MeSH Indexing)

Diagnosis, Differential

Epilepsy/diagnosis*

Humans

Syncope/diagnosis*

Tongue*


Find related publications in this database (Keywords)

Epileptic seizures
Likelihood ratio
Meta-analysis
Sensitivity
Specificity
Syncope
Tongue biting