Psychogenic seizures: clinical features and psychological analysis

Approximately 25-30% of patients referred to epilepsy centers for refractory epilepsy are found to have nonepileptic seizures (NES). In many cases psychological assessments are performed to evaluate for underlying psychiatric disorders. The authors analyzed the clinical features of 23 patients with NES and correlated the features with underlying psychological status. Thirteen of the twenty-three patients (56.5%) had motor manifestations and 10 presented with limpness and unresponsiveness. There was no significant difference in the occurrence of depression, anxiety, posttraumatic stress disorder, or malingering between patients with limpness and those with motor manifestations. However, only patients with motor manifestations had a history of sexual and physical abuse. Those with limp and unresponsive presentations were less likely to have a history of sexual and/or physical abuse. This finding may help treating physicians to choose optimum psychiatric treatment for patients with NES. Additional studies are needed to clarify the association.