Psychogenic seizures in children and adolescents: outcome after diagnosis by ictal video and electroencephalographic recording.

Abstract:

:Psychogenic seizures in 21 nonepileptic children and adolescents, aged 8 to 18 (mean 14.5) years, were recorded by means of video recording and electroencephalography. The episodes included thrashing movements, limb jerking, or staring, with unresponsiveness. Ictal and interictal electroencephalograms showed no abnormalities after antiepileptic medication was discontinued. Fifteen patients had psychogenic seizures spontaneously during recording, and six had seizures in response to suggestion and intravenous saline injection. After the video-electroencephalographic evaluation, patients and families were told that the episodes were emotional in origin. All patients but 1 agreed to remain without antiepileptic medication, and 16 patients (76%) agreed to begin psychiatric treatment. At 6 to 66 (mean 30) months' follow-up, 14 of 18 (78%) were free of episodes. These data indicate that the majority of young patients with psychogenic seizures have a good outcome. A firm diagnosis is critical so that the episodes can be classified and emphasized as medically not worrisome, permitting a shift away from antiepileptic medication and toward psychiatric treatment.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Wyllie E,Friedman D,Rothner AD,Luders H,Dinner D,Morris H 3rd,Cruse R,Erenberg G,Kotagal P

subject

Has Abstract

pub_date

1990-04-01 00:00:00

pages

480-4

issue

4

eissn

0031-4005

issn

1098-4275

journal_volume

85

pub_type

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