Panayiotopoulos Syndrome: A Disorder Easily Misdiagnosed as Other Emergent Disorders in Children

Objectives: The present study elucidated the clinical characteristics and outcomes of Panayiotopoulos syndrome (PS) in children and highlighted how easily PS can be confused with other neurological and non-neurological disorders given its typical and atypical presentations. Methods: From 2012 to 2017, we enrolled 25 patients with PS, all of whom satisfied the following criteria: (a) ictal emetic symptoms (e.g., nausea, retching, and vomiting, alone or in combination; (b) onset age from 2 to 15 years; (c) normal development of neurological and mental states; (d) normal brain imaging, if performed; and (e) abnormal electroencephalogram (EEG). The patients were divided into two groups: typical presentations (impairment of consciousness, vomiting, nausea, pallor, miosis, and hypersalivation) and atypical presentations (less common symptoms of PS). Results: We observed that on the basis of typical presentations, PS was most commonly misdiagnosed as encephalitis, gastroenteritis/GERD, syncope, and other seizure disorders and less commonly as septic shock, basilar migraine, or cyclic vomiting on the basis of atypical presentations. Conclusions: This is the study of PS in Taiwan that demonstrated the misdiagnosis of PS cases as other emergent disorders on the basis of its typical and atypical presentations. This study demonstrated the misdiagnosis of PS cases as other emergent disorders on the basis of its typical and atypical presentations and raised awareness regarding this easily misdiagnosed epileptic syndrome.