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Pseudoepilepsy: a study in adolescent hysteria

M Gross

    The American Journal of Psychiatry
    |February 1, 1979
    PubMed
    Summary
    This summary is machine-generated.

    Psychogenic seizures in adolescents, including hysterical convulsions and amnesiac fugues, are often misdiagnosed as epilepsy. Early consideration of psychogenic factors is crucial for accurate diagnosis and treatment in pediatric patients.

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    Area of Science:

    • Neurology
    • Psychiatry
    • Adolescent Medicine

    Background:

    • Psychogenic seizures are a significant diagnostic challenge in adolescents.
    • Misdiagnosis can lead to inappropriate and prolonged treatment with anticonvulsant medication.

    Purpose of the Study:

    • To analyze the clinical presentation and diagnostic outcomes of psychogenic seizures in a cohort of adolescents.
    • To highlight the importance of considering psychogenic etiology in adolescent seizure disorders.

    Main Methods:

    • Retrospective case series analysis of 19 adolescents diagnosed with psychogenic seizures.
    • Review of initial diagnoses, presenting symptoms (hysterical convulsions, amnesiac fugues), and final psychiatric diagnoses (hysterical neurosis, schizophrenia, borderline psychosis).

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    Main Results:

    • 13 adolescents presented with hysterical convulsions, and 4 with amnesiac fugues.
    • 16 received a diagnosis of hysterical neurosis, 2 of process schizophrenia, and 1 of borderline psychosis.
    • 13 patients were initially misdiagnosed with epilepsy and received anticonvulsant treatment for an average of 15 months.

    Conclusions:

    • Psychogenic seizures are prevalent in adolescents and frequently misdiagnosed as epilepsy.
    • Therapists must consider psychogenic factors in the differential diagnosis of seizures in children and adolescents.
    • Accurate diagnosis is essential to avoid ineffective and potentially harmful treatments.