Letters

Head up tilt testing has a place in distinguishing certain conditions from epilepsy

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7086.1048 (Published 05 April 1997) Cite this as: BMJ 1997;314:1048
  1. Amir Zaidi, Research fellowa,
  2. Lawrence Cotter, Consultant cardiologista,
  3. Adam Fitzpatrick, Consultant cardiologista
  1. a Autonomic Function Department, Manchester Heart Centre, Royal Infirmary, Manchester M13 9WL

    Editor—In their editorial J W A S Sander and M F O'Donoghue place great reliance on clinical characteristics to differentiate between epilepsy, convulsive syncope, and non-epileptic attacks.1 This seems unwise because the diagnostic success rate even of specialists may be as low as 50% on the basis of history and examination alone.2 Furthermore, direct observation of seizures by trained staff in a specialised inpatient unit resulted in only 80% diagnostic accuracy.2

    One important omission in the editorial was the failure to mention head up tilt testing, which has assumed …

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