{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:05:30Z","timestamp":1767164730828,"version":"build-2238731810"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>\n                      Misdiagnosis of refractory epilepsy (\n                      <jats:styled-content style=\"fixed-case\">rE<\/jats:styled-content>\n                      ) is common and such patients experience a long diagnostic delay. Our aim was to identify key clinical\/laboratory factors in order to obtain an alternative diagnosis in patients referred for\n                      <jats:styled-content style=\"fixed-case\">rE<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Between January 2010 and December 2015, 125 consecutive patients with a diagnosis of\n                      <jats:styled-content style=\"fixed-case\">rE<\/jats:styled-content>\n                      were prospectively enrolled. All patients underwent a comprehensive neurological, neuropsychiatric and cardiological evaluation, and had an observation time of at least 1 year after the study entry.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Diagnosis of\n                      <jats:styled-content style=\"fixed-case\">rE<\/jats:styled-content>\n                      was confirmed in 104\/125 (83.2%) patients (55 women, mean age 38.8 \u00b1 14.3 years). Thirteen\/125 patients (10.4%, seven women, mean age 50.8 \u00b1 20.9) were diagnosed with syncope, which was cardiac\/cardio inhibitory in 9\/13 (69%). The remaining 8\/125 patients (6.4%, six women, mean age 41.2 \u00b1 14.6 years) were diagnosed with psychogenic non\u2010epileptic seizures. Age at onset had a high accuracy in differentiating patients with syncope from others, with the best cut\u2010off age at 35 years and above. Abnormal brain magnetic resonance imaging (\n                      <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>\n                      ) had a significant yield of about 70% in\n                      <jats:styled-content style=\"fixed-case\">rE<\/jats:styled-content>\n                      . A diagnostic model including age at onset and brain\n                      <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>\n                      was highly accurate in differentiating patients with syncope from others. In patients with cardiac\/cardio inhibitory syncope, the point score of historical features was \u22651 and falsely favoured the diagnosis of epileptic seizures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This prospective cohort study identifies rE mimics who are at high risk of morbidity and mortality. rE starting in adulthood should raise a high suspicion of cardiac syncope. Brain\n                      <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>\n                      is accurate in differentiating\n                      <jats:styled-content style=\"fixed-case\">rE<\/jats:styled-content>\n                      from other conditions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.13579","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T23:42:39Z","timestamp":1516664559000},"page":"711-717","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Value of clinical features to differentiate refractory epilepsy from mimics: a prospective longitudinal cohort study"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8827-7324","authenticated-orcid":false,"given":"A.","family":"Labate","sequence":"first","affiliation":[{"name":"Institute of Neurology University Magna 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