The case for a dissociative interpretation of pseudoepileptic seizures

A pseudoepileptic seizure (PES) can be considered as a paroxysmal behavior pattern that mimics epilepsy and is initiated by psychological mechanisms. There is no evidence that the symptomatology of PES forms a specific syndrome. This paper presents evidence for the explanatory value of the concept of dissociation in at least a subgroup of PES. Characteristics of patients with PES and possible factors in the etiology of PES are reviewed. Based on the dissociation hypothesis, some suggestions are offered to explain the relatively high comorbidity of PES and epilepsy.