Objective To investigate the causes of misdiagnosis and preventive measures of epilepsy secondary to vascular cognitive impairment(VCI).Methods The clinical data of 5 patients with misdiagnosed epilepsy secondary to VCI treated from July 2023 to December 2023 were retrospectively analyzed.Results Two unresponsive patients were initially di-agnosed with cerebral infarction and VCI,and the corresponding treatment was not effective.A patient with slurred speech was diagnosed with cerebral infarction and VCI after ambulatory electroencephalography(EEG)examination in another hospital without epileptic discharge.After treatment,the symptoms worsened again and the patient was diagnosed as cerebral infarc-tion.One patient with intermittent dizziness and significant basilar artery stenosis was diagnosed with vertebrobasilar transient ischemic attack and VCI.One patient with dizziness was diagnosed with otoliths and VCI,and the corresponding treatment was not effective.All the 5 patients were diagnosed with epilepsy after repeated inquiry about medical history and understanding of the characteristics of the disease,and epileptic discharge was found by ambulatory EEG.Misdiagnosis lasted 5 d to 6 months.After diagnosis,the symptoms disappeared after oral administration of Sodium Valproate,and no epileptic discharge was found in EEG reexamination 2 weeks afterwards.Conclusion Patients with epilepsy secondary to VCI are prone to misdiagnosis due to unclear medical history and atypical clinical manifestations.When treating patients with suspected epilepsy secondary to VCI,doctors should carefully and repeatedly inquire about the medical history,strengthen their understanding of special clini-cal manifestations of epilepsy,and pay attention to the diagnostic value of ambulatory EEG for special types of epilepsy,so as to reduce misdiagnosis of this disease.
维普
万方数据