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Nonepileptic Seizures: An Overview

Published online by Cambridge University Press:  07 November 2014

Abstract

Since before the time of Charcot, nonepileptic seizures (NES) have intrigued and perplexed physicians. With the advent of the electroencephalogram, particularly with the addition of continuous video monitoring, the diagnosis of NES has received increasing evaluation. Characteristic historical features and clinical signs of NES, coupled with new diagnostic techniques, have progressively refined our understanding of the disorder. The treatment of patients who have NES has received much less attention and the prognosis of these patients illustrates the need for a more comprehensive, systematic, and validated intervention. These issues are discussed with an emphasis on the need for future research.

Type
Feature Articles
Copyright
Copyright © Cambridge University Press 2001

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References

REFERENCES

1. Krumholz, A. Nonepileptic seizures: diagnosis and management. Neurology. 1999;53:S76S83.Google ScholarPubMed
2. Gates, JR. Epidemiology and classification of non-epileptic events. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterwort-Heinemann; 2000:314.Google Scholar
3. Ramani, V. Review of psychiatric treatment strategies in non-epileptic seizures. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 1993:259267.Google Scholar
4. van der Kolk, BA, van der Hart, O. Pierre Janet and the breakdown of adaptation in psychological trauma. Am J Psychiatry. 1989;12:15301540.Google Scholar
5. Szaflarski, JP, Ficker, DM, Cahill, WT, et al. Four-year incidence of psychogenic nonepileptic seizures in adults in Hamilton County, OH. Neurology. 2000;55:15611563.CrossRefGoogle ScholarPubMed
6. Sigurdardottir, KR, Olafsson, E. Incidence of psychogenic seizures in adults: a population-based study in Iceland. Epilepsia. 1998;39:749752.CrossRefGoogle ScholarPubMed
7. King, DW, Gallagher, BB, Murvin, AJ, et al. Pseudoseizures: diagnostic evaluation. Neurology. 1982;32:1823.CrossRefGoogle ScholarPubMed
8. Rowan, AJ. Diagnosis of non-epileptic seizures. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 2000:1530.Google Scholar
9. Anderman, F. Non-epileptic paroxysmal neurologic events. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 2000:5169.Google Scholar
10. Devinsky, O, Paraiso, JO. Unusual epileptic events and non-epileptic seizures: differential diagnosis and coexistence. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 2000:3150.Google Scholar
11. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
12. Bowman, ES, Markland, ON. Psychodynamics and psychiatric diagnoses of pseudoseizure subjects. Am J Psychiatry. 1996;153:5763.Google ScholarPubMed
13. Alper, K, Devinsky, O, Perrine, K, et al. Dissociation in epilepsy and conversion nonepileptic seizures. Epilepsia. 1997;38:991997.CrossRefGoogle ScholarPubMed
14. Lesser, RP. Psychogenic seizures. Neurology. 1996;46:14991507.CrossRefGoogle ScholarPubMed
15. Blumer, D. On the psychobiology of non-epileptic seizures. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann. 2000:305310.Google Scholar
16. Mahowald, MK, Schenck, . Parasomnia purgatory: epileptic/non-epileptic parasomnia interface. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann. 2000:7194.Google Scholar
17. Peguero, E, Aboul-Khalil, B, Fakhoury, T, et al. Self-injury and incontinence in psychogenic seizures. Epilepsia. 1995;36:586591.CrossRefGoogle ScholarPubMed
18. Barry, JJ, Atzmon, O, Morrell, M. Discriminating between epileptic and nonepileptic events: the utility of hypnotic seizure induction. Epilepsia. 2000;41:8184.CrossRefGoogle ScholarPubMed
19. Walczac, TS, Williams, DT, Berten, W. Utility and reliability of placebo infusion in the evaluation of patients with seizures. Neurology. 1994;44:394399.CrossRefGoogle Scholar
20. Lancman, ME, Asconape, JJ, Craven, WJ, et al. Predictive value of induction of psychogenic seizures by suggestion. Ann Neurol. 1994;35:359361.CrossRefGoogle ScholarPubMed
21. Bowman, ES. Nonepileptic seizures: psychiatric framework, treatment, and prognosis. Neurology. 1999;53:S84–S88.Google Scholar
22. Terr, LC. Childhood trauma: an outline and overview. Am J Psychiatry. 1991;148:1020.Google ScholarPubMed
23. Breier, JI, Fuchs, KL, Brookshire, BL. Quality of life perception in patients with intractable epilepsy or pseudoseizures. Arch Neurol. 1998;55:660665.CrossRefGoogle ScholarPubMed
24. Van der Kolk, BA. The body keeps the score: approaches to the psychobiology of posttraumatic stress disorder. In: Traumatic Stress: The Overwhelming Experience of Mind, Body, and Society. New York, NY: Guilford Press; 1996:214241.Google Scholar
25. Risse, GL, Mason, SL, Mercer, K. Neuropsychological performance and cognitive complaints in epileptic and nonepileptic patients. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 2000:139150.Google Scholar
26. Swanson, SJ, Springer, JA, Bendadis, SR. Cognitive and psychological functioning in patients with non-epileptic seizures. In: Gates, JR, Rowan, AJ, eds. Non-Epikptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 2000:123138.Google Scholar
27. Lelliott, PT, Fenwick, P. Cerebral pathology in pseudoseizures. Acta Neurol Scand. 1991;83:129132.CrossRefGoogle ScholarPubMed
28. Ritter, F, Kotagal, P. Non-epileptic seizures in children. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 2000:95110.Google Scholar
29. Dreifuss, F, Gates, J. Munchausen syndrome by proxy and Senegal syndrome. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann. 2000:237244.Google Scholar
30. Barry, JJ, Lembke, A, Huynh, N. Affective disorders in epilepsy. In: Ettinger, A, Kanner, A, eds. Psychiatric Issues in Epilepsy: A Practical Guide to Diagnosis and Treatment. Philadelphia, Pa: Lippincott, Williams & Wilkins; 2001:4572.Google Scholar
31. Dodrell, CB, Wilkus, RJ, Batzel, LW. The MMPI as a diagnostic tool in non-epileptic seizures. In: Gates, JR, Rowan, AJ, eds. Non-Epileptic Seizures. 1st ed. Boston, Mass: Butterworth-Heinemann; 1993:211219.Google Scholar
32. Tigaran, S, O'Brien, TJ, Cascino, GD. Advances in neuroimaging: non-sub-strate-directed partial epilepsy. Current Neurology and Neuroscience Reports. 2001;1:361368.CrossRefGoogle ScholarPubMed
33. Spanski, MV, MacMullan, J, Spenser, SS, et al. The role of quantitative ictal SPECT analysis in the evaluation of nonepileptic seizures. J Neuroimaging. 1999;9:210216.CrossRefGoogle Scholar
34. Fisher, RS. Serum prolactin in the diagnosis of epilepsy. In: Fisher, R, ed. Imitators of Epilepsy. New York, NY: Demos Publications; 1994:8190.Google Scholar
35. Fisch, B. Generalized tonic-clonic seizures. In: Wyllie, E, ed. The Treatment of Epilepsy: Principles and Practice. 2nd ed. Baltimore, Md: Williams & Wilkins; 1996:502521.Google Scholar
36. Stagno, SJ, Smith, ML. The use of placebo in diagnosing psychogenic seizures: who is deceived? Semin Neurol. 1997;17:213218.CrossRefGoogle ScholarPubMed
37. Devinsky, O, Fisher, R. Ethical use of placebos and provocative testing in diagnosing nonepileptic seizures. Neurology. 1996;47:866867.CrossRefGoogle ScholarPubMed
38. Ramani, V. Treatment of the adult patient with non-epileptic seizures. In: Gates, J, Rowan, A, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 2000;311316.Google Scholar
39. Barry, JJ, Sanborn, K. Etiology, diagnosis and treatment of nonepileptic seizures. Current Neurology and Neuroscience Reports. 2001;1:381389.CrossRefGoogle ScholarPubMed
40. Gumnit, RJ. Inpatient multidisciplinary management of non-epileptic seizures. In: Gates, J, Rowan, A, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 1993:2130.Google Scholar
41. Bowman, ES. Relationship of remote and recent life events to the onset and course of non-epileptic seizures. In: Gates, J, Rowan, A, eds. Non-Epileptic Seizures. 2nd ed. Boston, Mass: Butterworth-Heinemann; 2000:269283.Google Scholar
42. Krumholz, A, Niedermeyer, E. Psychogenic seizures: a clinical study with follow-up data. Neurology. 1983;33:498504.CrossRefGoogle ScholarPubMed
43. Lempert, T, Schmidt, D. Natural history and outcome of psychogenic seizures: a clinical study in 50 patients. J Neurol. 1990;237:3538.CrossRefGoogle ScholarPubMed
44. Wyllie, E, Friedman, RN, Luders, H, et al. Outcome of psychogenic seizures in children and adolescents compared with adults. Neurology. 1991;41:742744.CrossRefGoogle ScholarPubMed
45. Kristensen, O, Alving, J. Pseudoseizures-risk factors and prognosis. Acta Neurol Scand. 1992;85:177180.CrossRefGoogle ScholarPubMed
46. McDade, G, Brown, S. Non-epileptic seizures: management and predictive factors of outcome. Seizure. 1992;1:710.CrossRefGoogle ScholarPubMed
47. Buchanan, N, Snars, J. Pseudoseizures (nonepileptic attack disorder)—clinical management and outcome in 50 patients. Seizure. 1993;2:141146.CrossRefGoogle Scholar
48. Walczak, TS, Papacostas, S, Williams, DT, et al. Outcome after diagnosis of psychogenic nonepileptic seizures. Epilepsia. 1995;36:11311137.CrossRefGoogle ScholarPubMed
49. Aboukasm, A, Mahr, G, Gahry, BR, et al. Retrospective analysis of the effects of psychotherapeutic interventions on outcomes of psychogenic seizures. Epilepsia. 1998;39:470473.CrossRefGoogle Scholar
50. Ettinger, AB, Dhoon, A, Weisbrot, DM, et al. Predictive factors for outcome of nonepileptic seizures after diagnosis. J Neuropsychiatry Clin Neurosci. 1999;11:458463.CrossRefGoogle ScholarPubMed
51. Kanner, AM, Parra, J, Frey, M. Psychiatric and neurologic predictors of psychogenic pseudoseizure outcome. Neurology. 1999;53:933938.CrossRefGoogle ScholarPubMed
52. Bowman, E. Psychopathology and outcome in pseudoseizures. In: Ettinger, A, Kanner, A, eds. Psychiatric Issues in Epilepsy: A Practical Guide to Diagnosis and Treatment. Philadelphia, Pa: Lippincott, Williams & Wilkins; 2001:355377.Google Scholar
53. Hayward, C, Garfield, L, Barry, JJ, et al. Somatization illness role and personality disturbance. Medicine and Psychiatry. 1998;1:7579.Google Scholar
54. Katon, W, Kleinman, A, Rosen, G. Depression and somatization: a review—part 1. Am J Med. 1982;72:127135.CrossRefGoogle Scholar
55. Trimble, MR. Pseudoseizures. In: Ponter, RJ, Theodore, WH, eds. Neurology Clinics. Philadelphia, Pa: W.B. Saunders & Company; 1986:561–548.Google Scholar