Practitioner review: Recognition of pseudoseizures in children and adolescents

Pseudoseizures or their possibility remain a troublesome clinical issue with serious implications as, particularly in older children and adolescents, they can take various forms so that their differential diagnosis is wide. Many of the traditional criteria do not, in fact, discriminate well between pseudoseizures and other episodic disorders, especially those involving dramatic behavioural manifestations. These include certain forms of epilepsy (notably mesial frontal seizures) and some other organic and psychiatric conditions. A number of more reliable diagnostic criteria remain. These include selective clinical criteria and certain findings from carefully conducted EEG monitoring with informed analysis of the results.