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Good Positive and Negative Likelihood Ratios

Good Positive Likelihood Ratio

Negative Findings

Epilepsy: Likelihood Ratios

Introduction: aka seizure. See also Syncope as a differential diagnosis.

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Tags: Neurologic Tag this Diagnosis.

Differential Diagnoses include: Syncope

The likelihood ratios of findings for Epilepsy are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding +LR-LR Comments, Study
Postictal Confusion Edit 30.1

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Abnormal Behavior Edit 2.80.1

noted by bystanders

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Unresponsiveness Edit 3.10.3

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Limb Jerking Edit 5.80.4

noted by bystanders

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Interictal EEG
Duplicate Edit
12.50.5

Paper in Portuguese. Not read in full. Sensitivity 50-55%, upper limit of specificity 96%.

Study: Acta Med Port. 2004 Nov-Dec;17(6):465-70. Epub 2005 Jan 18. PMID: 16197858

Amnesia Edit 4.10.5

i.e. does not recall behavior during event

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Provoked by Stress Edit 3.80.5

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Good Positive Likelihood Ratio

Finding +LR-LR Comments, Study
Interictal EEG
Duplicate Edit
580.7

EEG findings are spikes or sharp waves, most often at the epileptogenic focus.

Sensitivity may be as high as 50% (depending on the study). Serial EEGs increase sensitivity up to 92% by 4 studies in one referenced case series.

Study: Epilepsia. 2006;47 Suppl 1:14-22. PMID: 17044820

Epilepsia. 1987 Jul-Aug;28(4):331-4. PMID: 3622408

Cut Tongue Edit 150.6

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Head Turning Edit 14.30.6

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Unusual Posturing Edit 11.70.7

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Elevated Prolactin Edit 11.50.6

within 10-20min after event. This is for complex partial. Sensitivity up to 60% with generalized tonic-clonic.

Study: Neurology. 2005 Sep 13;65(5):668-75. PMID: 16157897

Urinary Incontinence Edit 5.80.8

aka "bedwetting"

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Cyanosis Edit 5.50.7

observed by bystanders

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Prodromal Trembling Edit 4.80.8

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Prodromal Preoccupation Edit 4.30.9

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Prodromal Hallucinations Edit 40.9

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Prodromal Deja Vu Edit 3.50.9

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Myalgia Edit 3.20.9

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Postictal Headache Edit 2.90.6

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Negative Findings

Finding +LR-LR Comments, Study
Palpitations Edit 0.11.5

presyncopal

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Presyncopal Dyspnea Edit 0.11.3

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

History of Coronary Artery Disease Edit 0.11.3

(history of)

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Syncope with Standing Edit 0.11.6

(history of)

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Presyncopal Warmth Edit 0.21.4

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Chest Pain
Duplicate Edit
0.21.7

ever

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Presyncopal Nausea Edit 0.21.3

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Remembered Loss of Consciousness Edit 0.22.1

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Presyncope with Standing Edit 0.21.4

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Presyncopal Diaphoresis Edit 0.21.4

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Chest Pain
Duplicate Edit
0.21.1

presyncopal

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Self-Reported High Blood Pressure Edit 0.31.3

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Presyncope with Heat Edit 0.31.3

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Presyncope with Needle Edit 0.31.1

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Vertigo Edit 0.31.2

prodromal

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Presyncopal Episodes
Duplicate Edit
0.35.6

ever / of any type

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Hypertension Edit 0.31.3

physician-measured

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268

Presyncopal Episodes
Duplicate Edit
0.42.6

before actual syncope, by history

Differential Diagnosis: Syncope

Study: J Am Coll Cardiol. 2002 Jul 3;40(1):142-8. PMID: 12103268