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Psychogenic seizures in old age: a case report
T Fakhoury1, B Abou-Khalil, K Newman
1Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37212.
Epilepsia
|November 1, 1993
Summary
Late-onset psychogenic seizures can occur in elderly individuals, even after age 60. This case highlights that nocturnal seizures and a history of abuse are important diagnostic considerations.
Area of Science:
- Neurology
- Psychiatry
Background:
- Psychogenic seizures are typically diagnosed in younger populations.
- Late-onset seizures warrant thorough differential diagnosis.
Observation:
- A 73-year-old woman experienced new-onset psychogenic seizures at age 69.
- Attacks occurred nocturnally, characterized by specific ictal semiology.
- Continuous EEG-CCTV monitoring confirmed nonepileptic events.
Findings:
- No epileptiform discharges were observed during monitoring.
- Discontinuation of antiepileptic drugs did not alter seizure frequency or intensity.
- Psychiatric evaluation revealed significant life stressors and a history of abuse.
Implications:
- Psychogenic seizures should be considered in the differential diagnosis of elderly patients with intractable seizures.
- Nocturnal seizure presentation does not rule out psychogenic seizures.
- Understanding patient history is crucial for accurate diagnosis and management.