Factitious psychogenic nonepileptic paroxysmal episodes.
Alissa Romano1, Saeed Alqahtani1, James Griffith2
1Department of Neurology, George Washington University, Washington, DC, USA.
Epilepsy & Behavior Case Reports
|February 11, 2015
Summary
Misdiagnosing psychogenic nonepileptic episodes (PNEPEs) as epileptic seizures (ES) can be dangerous. This case highlights factitious disorder, where a patient faked seizures, leading to unnecessary treatments and risks.
Area of Science:
- Neurology
- Psychiatry
Background:
- Misdiagnosis of psychogenic nonepileptic paroxysmal episodes (PNEPEs) as epileptic seizures (ES) poses significant risks.
- Factitious seizures, a subtype of PNEPEs, are associated with high morbidity and mortality due to inappropriate treatments.
Purpose of the Study:
- To report a case of PNEPEs misdiagnosed as ES in a patient with factitious disorder.
- To highlight clinical features that can help differentiate PNEPEs from ES.
Main Methods:
- Continuous video-electroencephalogram (EEG) monitoring was used to evaluate the patient's episodes.
- Clinical observation and patient history were analyzed to identify deceptive behaviors.
Main Results:
- The patient exhibited episodes mimicking ES, including generalized stiffening, cyanosis, and jerking.
- Video-EEG monitoring showed no epileptic activity; episodes ceased when the patient was unaware.
- Evidence suggested the patient intentionally caused symptoms, such as self-induced bleeding, consistent with factitious disorder.
Conclusions:
- Differentiating PNEPEs from ES is crucial for appropriate patient management.
- Factitious disorder should be considered in patients with PNEPEs who exhibit deceptive behaviors.
- Accurate diagnosis prevents unnecessary and potentially harmful treatments for patients with PNEPEs.
Keywords:
EpilepsyFactitious disorderPseudoseizuresPsychogenic nonepileptic paroxysmal episodesVideo-EEGMore Related Videos
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