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Pseudoseizures: diagnostic evaluation

D W King, B B Gallagher, A J Murvin

|January 1, 1982

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Pseudoseizures are common in epilepsy evaluations and often misdiagnosed. Prolonged video-electroencephalography (EEG) recording is crucial for accurate diagnosis, distinguishing pseudoseizures from epileptic seizures.

Area of Science:

Neurology
Clinical Neurophysiology

Background:

Differentiating between epileptic seizures and pseudoseizures is clinically challenging.
Misdiagnosis can lead to inappropriate treatment and management.

Purpose of the Study:

To evaluate the frequency of pseudoseizures in patients undergoing evaluation for epilepsy.
To assess the diagnostic accuracy of clinical assessment versus prolonged video-electroencephalography (EEG) recording.

Main Methods:

A prospective study involving 60 patients with uncertain or presumed uncontrolled seizures.
Utilized prolonged video-electroencephalography (EEG) recording for episode capture and analysis.

Main Results:

Of 33 patients with uncertain episodes, 18 (55%) received a diagnosis: 12 (36%) had pseudoseizures, and 6 (18%) had epileptic seizures.

Related Experiment Videos

Four of 27 patients (15%) with presumed uncontrolled epileptic seizures were found to have pseudoseizures.

Clinical prediction by neurologists was 67% accurate; unit personnel and neurologists' observations were <80% accurate.

Conclusions:

Pseudoseizures are frequently encountered in patients evaluated for epilepsy.
Clinical differentiation between epileptic and pseudoseizures is often inaccurate.
Prolonged video-EEG recording significantly aids in accurate diagnosis.