Rhythmic jerking while asleep which stop if gently woken are frequently misdiagnosed as epilepsy in children. A British Medical Journal reports 15 cases of misdiagnosis, seven of which resulted in anticonvulsant medication for periods ranging from three months to seven years, without benefit. And a reader reports it's not just children.

A few years ago, while living in the UK, my then 32 year old very fit healthy husband started to have nocturnal partial seizures (or so it seemed). He was extensively and exhaustively investigated, which was very reassuring. He was told he had epilepsy, put on carbamazepine, and had to leave his job as a result as his work involved driving.

On our second and final visit to the neurologist he was told "there is nothing wrong with you". I took issue with this and asked why in that case he was on antiepileptic drugs, had been told to revoke his driving licence, and had been told he had epilepsy. Eventually we were reduced to the degrading situation of borrowing a video camera to tape these episodes, we felt so much like no-one believed us. On watching the recordings, he was clearly experiencing episodes of paroxysmal nocturnal myoclonus - which I later discovered as an entity in the small print in big fat textbooks.

To cut a long story short, I concluded the problem was stress related - or more accurately, bullying at work (in a very subtle, unobtrusive way) - the bullier (a colleague) took a dislike to him when he made a polite request of the boss to work elsewhere as the open plan office which was full of smokers was causing him some discomfort.

I have learnt from this that stress can cause all sorts of symptoms - and that when specialists say there is nothing wrong with the patient, what they mean is they don't know what is wrong - and frequently have not looked beyond the physical in their considerations. - by email, NZ

Further reading: Benign sleep myoclonus of infancy mistaken for epilepsy http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125884/?tool=pubmed

Differentiating between nonepileptic and epileptic seizures. http://www.ncbi.nlm.nih.gov/pubmed/21386814

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