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Pseudoseizure manifestations in two preschool age children
L Carmant1, U Kramer, M A Mikati
1Department of Neurology, Children's Hospital, Harvard Medical School, USA.
Insights
Two pediatric patients with epilepsy experienced intractable staring spells diagnosed as pseudoseizures. These seizures were provoked and stopped by suggestion, highlighting the need for careful diagnosis before medication adjustments.
Area of Science:
- Neurology
- Pediatrics
- Psychiatry
Background:
- Epilepsy in children can present with varied symptoms, including staring spells.
- Differentiating true epileptic seizures from non-epileptic phenomena is crucial for effective treatment.
Observation:
- Two 6-year-old patients presented with intractable staring spells suggestive of epilepsy.
- Pseudoseizures were successfully provoked and aborted through suggestion in both cases.
Findings:
- The patients were diagnosed with epilepsy presenting as pseudoseizures.
- Neuropsychological disturbances were identified, leading to the initiation of psychotherapy.
Implications:
- Monitoring staring episodes is recommended before increasing antiepileptic drug dosages or using polytherapy.
- Accurate differentiation of non-epileptic phenomena is essential for appropriate therapeutic interventions in pediatric epilepsy.
Abstract:
We report two patients with epilepsy with pseudoseizures at age 6 years. Both presented with intractable staring spells. Pseudoseizures were provoked and aborted by suggestion, leading to the diagnosis. In both patients, evidence of a neuropsychological disturbance was later found and psychotherapy started. Monitoring of intractable staring episodes is recommended prior to escalating antiepileptic drug levels or resorting to polytherapy. In addition, differentiation from other non-epileptic phenomena is necessary to initiate proper therapy.