Types of childhood epilepsy misdiagnosed as psychiatric disorder

Nonconvulsive seizures, which are a common form of epileptic attack, are often misdiagnosed as psychological disorder. This is especially true of frontal complex partial seizures (accurately described in childhood only recently) and nonconvulsive status epilepticus. Two recent series of children with these conditions are described mainly from the point of view of the difficulties encountered in recognising such seizures. These difficulties arise from physicians' limited awareness of these forms of epilepsy but also from the unusual clinical manifestations (in the case of frontal complex partial seizures) and the variable clinical picture in children with nonconvulsive status epilepticus. Pointers to the recognition of these conditions are given with brief discussion of their treatment and prognosis. It is argued that psychiatrists (and other physicians) need to be more familiar with these nonconvulsive types of epilepsy.