Suggestive seizure induction techniques in paediatric functional/dissociative seizures: an extensive protocol.

Area of Science:

• Neuroscience
• Psychiatry
• Pediatrics

Background:

• Functional/Dissociative Seizures (FDS) are often misdiagnosed as epilepsy in pediatric patients.
• Diagnosis is challenging, especially when standard or prolonged EEG recordings are non-diagnostic.

Purpose of the Study:

• To evaluate the diagnostic utility of a structured, non-invasive Suggestive Seizure Induction Technique (SSIT) protocol integrated within video-EEG.
• To explore clinical correlates of seizure responses during SSIT in pediatric patients.

Main Methods:

• A retrospective study of 25 pediatric patients with suspected FDS, all with prior inconclusive EEGs.
• The SSIT protocol involved verbal suggestion, tuning fork, and soaked pad application during video-EEG.
• Analysis of seizure responses, somatoform/dissociative reactions, and psychological assessments.

Main Results:

• A seizure response to SSIT was observed in 52% of patients; 72% showed somatoform or dissociative reactions.
• Verbal suggestion and soaked pad techniques were most effective in eliciting responses.
• Seizure responses correlated significantly with dissociative symptoms and lower working memory scores.

Conclusions:

• SSIT can potentially accelerate the diagnosis of FDS in a stepwise diagnostic approach.
• The study highlights the relevance of dissociative symptoms and cognitive factors in pediatric FDS.
• Further research into SSIT's role in diagnosing FDS is warranted.