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NEW YORK, Jun 30 2000 (Reuters Health) - Many people thought to have epilepsy may have a heart problem instead, say British researchers.

In a study, researchers closely examined people diagnosed with epilepsy who did not respond well to medication or had symptoms unusual for the disorder. They found that more than 40% had another medical problem--most often a heart or circulation condition--that could have caused the symptoms.

"The key message is that misdiagnosis of epilepsy is common and that in many cases the true cause is cardiac," the study's lead author, Dr. Amir Zaidi, of the Manchester Heart Centre in the UK, told Reuters Health. People who are believed to have epilepsy, but whose symptoms are not controlled by medication, should be considered for several relatively simple tests to see whether a heart problem is to blame, he said.

In the study, Zaidi and his colleagues evaluated 74 people who had been diagnosed with epilepsy. Even though most were taking one or more epilepsy drugs, about half of the patients were still having seizures or other symptoms. Some had relatively unusual symptoms for epileptics--such as blacking out in the absence of convulsions.

When the researchers put the participants through a battery of tests, they discovered another potential cause of the symptoms in nearly 42% of the participants. In most cases, a heart or circulation problem was to blame, according to the report in the July issue of the Journal of the American College of Cardiology.

The most common alternate diagnosis was vasovagal syncope, or fainting spells, which can be caused by extremely low blood pressure, a heart-rhythm disorder or other conditions. Many of the heart and circulation problems could be treated with medication or a pacemaker, an electronic device that helps regulate the heartbeat, according to Zaidi.

Previous research had suggested that about 20% of people with epilepsy may actually have some other condition, a rate considerably lower than the current study. Of course, the study was not a representative sample of all people with epilepsy, since it mainly included people whose seizures and other symptoms were not under control. Still, Zaidi said that it is important to consider the possibility that a condition besides epilepsy may responsible for seizures, especially in people who do not benefit from medication.

Journal of the American College of Cardiology 2000;36:181-184.