Psychogenic seizures: ictal characteristics and diagnostic pitfalls.

Abstract:

:We analyzed ictal features of psychogenic seizures using video-EEG recordings in 47 patients and reviewed the medical records to determine if patients received antiepileptic drug therapy and whether they were treated pharmacologically for status epilepticus. Unresponsive behavior in the absence of motor manifestations was the single most common ictal presentation. Motor characteristics previously considered to distinguish psychogenic seizures (out-of-phase limb movements, side-to-side head movements, pelvic thrusting) were infrequent. Most patients (74%) received anticonvulsants, and six were treated as status epilepticus. Slow, subtle writhing or in-phase limb movements were most likely to be mistaken for status epilepticus. Physicians, assuming that the spells constituted a neurologic emergency, omitted the neurologic examination and chart review and proceeded with aggressive pharmacotherapy based merely on observation.

journal_name

Neurology

journal_title

Neurology

authors

Leis AA,Ross MA,Summers AK

doi

10.1212/wnl.42.1.95

subject

Has Abstract

pub_date

1992-01-01 00:00:00

pages

95-9

issue

1

eissn

0028-3878

issn

1526-632X

journal_volume

42

pub_type

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