Discussion One important step in the management of a patient with a history of seizure(s) is correct diagnosis of the illness. An important and sometimes problematic issue in the management of seizure is the differentiation of epileptic seizures from non-epileptic ones.1 Basically, epilepsy is a clinical diagnosis. Unless one happens to observe a seizure while recording

the EEG, which is a rare event in general clinical practice, the diagnosis relies on the judgment of a physician Inhibitors,research,lifescience,medical or other health care providers. This judgment ultimately rests on the history provided by the patient or others, which may be misleading and results in maltreatment, similar to the scenario, which happened in the case of the present patient. The history of seeing flashing light was interpreted as epileptic aura. The triggering factors such as pain and inspecting blood were overlooked,

and motor phenomena, loss of consciousness and post-ictal confusion led to the misdiagnosis Inhibitors,research,lifescience,medical of the illness. She had been diagnosed Inhibitors,research,lifescience,medical as having epilepsy for 16 years, however, normal EEGs and AED-unresponsiveness had been ignored. As others have mentioned in similar case reports, no one, even physicians who witness the events, is immune to making a false clinical diagnosis of epilepsy.3 Syncope is a condition that is most commonly misdiagnosed as epilepsy.4 The precise mechanism Inhibitors,research,lifescience,medical of vasovagal syncope is not fully understood. It is proposed that the failure of sympathetic efferent vasoconstrictor traffic occurs episodically and in response to a triggering agent such as fear, anger or pain.5 There is evidence for the involvement of both neural and chemical pathways.6 Presyncopal symptoms include lightheadedness, generalized muscle weakness, tinnitus Inhibitors,research,lifescience,medical and visual blurring, but up to a third of patients will have little or no GF109203X molecular weight prodrome. Often, unlike epileptic seizures, tonic-clonic convulsion, other motor phenomena, and

post-ictal confusion are uncommon features, but may occur.7 In the present case, injection (psychogenically)-induced asystole led to hypoxia, which in turn caused a typical tonic-clonic convulsion. Conclusion Carnitine dehydrogenase The possibility of vasovagal syncope should always be taken into consideration when evaluating patients with medically-refractory or unusual pattern of seizures. In such circumstances, simultaneous video-EEG/ECG monitoring may help achieve the correct diagnosis, particularly if the physician applies a triggering agent(s) after obtaining the patient’s consent. Conflict of Interest: None declared
Background: Brillantaisia lamium is an erect branched herb, which grows to a height of 1.50 m in moist tropical areas, both in full sun and partial shade. In , the aerial part of this plant is used in the treatment of various microbial infections such as skin diseases and infections of urinary tract.