BACKGROUND: Tongue biting (TB) may occur both in epileptic seizures and in syncope. A comprehensive search of the literature to determine the accuracy of this physical finding and its prevalence in epileptic seizures and syncope is still lacking. AIMS: To undertake a systematic review and a meta-analysis of studies evaluating the prevalence of TB in patients with epileptic seizures and syncope, and to determine sensitivity, specificity and likelihood ratios (LR) of this physical finding. METHOD: Studies comparing the prevalence of TB in epileptic seizures and syncope were systematically searched. Prevalence of TB was analyzed calculating odds ratio (OR) with 95% confidence intervals (CIs). Sensitivity, specificity, positive and negative likelihood ratio (pLR, nLR) of TB were determined for each study and for the pooled results. RESULTS: Two studies (75 epilepsy patients and 98 subjects with syncope) were included. There was a significantly higher prevalence of TB in patients with epileptic seizures (OR 12.26; 95% CI 3.99-37.69). Pooled accuracy measures of TB for the diagnosis of epileptic seizures were: sensitivity 33%, specificity 96%, pLR 8.167 (95% CI 2.969-22.461) and nLR 0.695 (95% CI 0.589-0.82). CONCLUSIONS: A pooled analysis of data from the literature shows that TB has great value in the differential diagnosis between epileptic seizures and syncope. Given a certain pre-test probability of seizures, the presence of TB greatly increases the chance that the patient had an epileptic seizure. Systematic reviews with pooled analyses (meta-analyses) of data from the literature allow an increase in statistical power and an improvement in precision, representing a useful tool to determine the accuracy of a certain physical finding in the differential diagnosis between seizures and other paroxysmal events.

Value of tongue biting in the differential diagnosis between epileptic seizures and syncope.

BRIGO, Francesco;BONGIOVANNI, Luigi Giuseppe
2012-01-01

Abstract

BACKGROUND: Tongue biting (TB) may occur both in epileptic seizures and in syncope. A comprehensive search of the literature to determine the accuracy of this physical finding and its prevalence in epileptic seizures and syncope is still lacking. AIMS: To undertake a systematic review and a meta-analysis of studies evaluating the prevalence of TB in patients with epileptic seizures and syncope, and to determine sensitivity, specificity and likelihood ratios (LR) of this physical finding. METHOD: Studies comparing the prevalence of TB in epileptic seizures and syncope were systematically searched. Prevalence of TB was analyzed calculating odds ratio (OR) with 95% confidence intervals (CIs). Sensitivity, specificity, positive and negative likelihood ratio (pLR, nLR) of TB were determined for each study and for the pooled results. RESULTS: Two studies (75 epilepsy patients and 98 subjects with syncope) were included. There was a significantly higher prevalence of TB in patients with epileptic seizures (OR 12.26; 95% CI 3.99-37.69). Pooled accuracy measures of TB for the diagnosis of epileptic seizures were: sensitivity 33%, specificity 96%, pLR 8.167 (95% CI 2.969-22.461) and nLR 0.695 (95% CI 0.589-0.82). CONCLUSIONS: A pooled analysis of data from the literature shows that TB has great value in the differential diagnosis between epileptic seizures and syncope. Given a certain pre-test probability of seizures, the presence of TB greatly increases the chance that the patient had an epileptic seizure. Systematic reviews with pooled analyses (meta-analyses) of data from the literature allow an increase in statistical power and an improvement in precision, representing a useful tool to determine the accuracy of a certain physical finding in the differential diagnosis between seizures and other paroxysmal events.
2012
epileptic seizures; likelihood ratio; meta-analysis; sensitivity and specificity; syncope; tongue biting
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/433337
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