Pamela Iddon and colleagues describe a systematic review that found that care staff and family carers may misinterpret epileptic and non-epileptic events

Aim Epilepsy is common among people with learning disabilities. It can be difficult to diagnose and may be misdiagnosed in one quarter of cases. This article describes a review conducted to explore how common the misdiagnosis of epilepsy is among people with learning disabilities, reasons for the misdiagnosis, the implications of misdiagnosis, and how to improve diagnosis.

Methods Primary studies and systematic reviews published in the English language between 1998 and 2008 were identified from electronic databases, experts, the internet, unpublished literature and citation tracking. Included studies were critically appraised using the appraisal tools produced by the Critical Appraisal Skills Programme at the Public Health Resource Unit in Oxford.

Results Eight studies were included in the review and critically appraised. Four broad themes emerged: methods of diagnosis; high levels of non-epileptic events which may be misdiagnosed as epilepsy by non-specialists, parents and support workers; the impact of misdiagnosis; and potential reasons for misdiagnosis.

Conclusion Those working in epilepsy and learning disability services and families should be aware of the possibility of misdiagnosis. Further research is needed into misdiagnosis and carers’ knowledge.