Pseudoseizures: Evaluation and Treatment

Dr. Griffith

Disclosures

Medscape Psychiatry & Mental Health eJournal. 1997;2(2) 

In This Article

Abstract & Introduction

Pseudoseizures are behavioral paroxysms that mimic epileptic seizures. They occur commonly, both in epileptic and nonepileptic individuals. Cross-cultural studies suggest that a pseudoseizure can be a nonverbal expression of distress about which words cannot be spoken, because of either a threat of physical danger or of unbearable shame or guilt. In this review, methods are outlined for a dual neuropsychiatric and psychosocial assessment for patients with putative pseudoseizures. The neuropsychiatric assessment focuses on the accurate distinction of pseudoseizures from epileptic seizures. The psychosocial assessment is aimed at identifying those patients who need protection from threat of physical or sexual assault, while engaging others in psychotherapy or family therapy that is conducted by a clinician with experience in treating somatoform symptoms.

Pseudoseizures are disturbances in behavior that superficially appear to be epileptic seizures, but upon clinical examination can be shown to be unrelated to any seizure discharge in the electroencephalogram (EEG) that would have characterized epilepsy. Characteristics of pseudoseizures include sudden staring, falling to the ground, jerking of extremities, and many other symptoms that involve motor or sensory symptoms or impaired consciousness. While there has been debate over the years as to what language best fits such phenomena, the term pseudoseizure will be used here because of its long tradition of usage.

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