Bispectral index monitoring during dissociative pseudo-seizure

Severe forms of dissociation or conversion can lead to events clinically often described as pseudo-seizures. Borderline personality disorder is a clinical condition which is often accompanied by a high susceptibility for dissociation and dissociative states are characterized by memory disturbance and perceptual alterations. We report a case of a patient with a complete anaesthesia, paralysis and amnesia for about 1 h. Within this time period we measured a bispectrum EEG index called BIS. Deepest recorded BIS value was 47. The described pattern of short but deep BIS reductions is completely discongruent to the findings during physiological sleep, during general anaesthesia, but very similar (and even more pronounced) to those during self-hypnosis. This makes former assumptions plausible that hypnosis and severe forms of dissociation (or conversion) may share common aetiologies.