Wait for it . . . . there's a punchline coming.
Here's the set up to the joke:
3 years ago I passed out and had a seizure while a nurse was drawing blood. Got an immediate referral from my GP to a neurologist in town, and thus began a new chapter in the ongoing love/hate relationship with doctors in general. We'll call that chapter "The Blackmailed Guinea Pig".
Fast forward through EEGs, MRIs, CT scans, tilt-table tests, heated arguements with two nurse practitioners, six anti-seizure drugs, a veritable plethora of anti-seizure drug reactions (including, but not limited to: killer temper tantrums, headaches, kidney stones, difficulty walking, insomnia, night terrors, fainting, seizures, palpitations, tremors, acne, and slurred speech), and a referral to a cardiologist.
In the meantime, I continue to talk myself blue in the face about inconsistencies in the diagnosis and what I know to be true for me. I do my own research, looking for the answers I don't feel they care to know. I play along because I have to, growing increasingly frustrated and angry with the medical establishment as a whole despite once aspiring to be one of them. We'll call that chapter "Die, Scum-Sucking Hippocratic Hypocrites!" (co-titled "I Need A Cookie, STAT!")
And I find a series of professional articles and studies that start to answer some questions. Finally.
This excerpt from The differential diagnosis of epilepsy: A critical review (S. Benbadis, Epilepsy & Behavior, Feb 2009) is a great lead-in to the punchline:
The wrong diagnosis of epilepsy is unfortunately common. Of patients diagnosed with epilepsy who are seen at at epilepsy centers, 20% to 30% are found to have been misdiagnosed. This percentage is astonishingly consistent across centers, countries, and continents. Psychogenic nonepileptic attacks are by far the most common condition found at referral epilepsy centers and epilepsy monitoring units, though syncope may be more common in a general neurology practice setting. . . As is true of other chronic conditions (e.g. multiple sclerosis), when a wrong diagnosis of epilepsy has been given, it is easily perpetuated without being questioned, which explains the usual diagnostic delay and its consequences. . . the delay in diagnosis remains long at about 7 to 10 years. This suggests that neurologists may not have a high enough index of suspicion to question the diagnosis of "seizures" when drugs fail.
[At this time, I'd like to point out that 1) I reported a family history of syncope, 2) I received the cardiologist referral because of the syncope, and 3) I was forced to try a number of anti-seizure drugs solely to control the syncope. Are we talking a low index of suspicion here or just plain medical interdedness? One wonders.]
And now, without further ado . . . I present to you the punchline . . . [drumroll, please]
Diagnosis: NO NEUROLOGICAL DISORDER PRESENT
Die, you scum-sucking hippocratic hypocrites . . . I'm off to have a celebratory cookie!
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