Pseudoseizures in the pediatric emergency department

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S M Selbst1, R Clancy

  • 1Department of Pediatrics, University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia 19104, USA.

Pediatric Emergency Care
|June 1, 1996
PubMed

Insights

Pediatric pseudoseizures are often misdiagnosed as generalized tonic-clonic seizures in emergency departments. Many children undergo unnecessary tests and treatments, including anticonvulsants, for these non-epileptic events.

Area of Science:

  • Neurology
  • Pediatrics
  • Emergency Medicine

Background:

  • Pseudoseizures, also known as psychogenic non-epileptic seizures (PNES), are often misdiagnosed in pediatric emergency settings.
  • Distinguishing PNES from epileptic seizures is crucial for appropriate patient management and resource allocation.

Observation:

  • This study reviewed 10 pediatric cases presenting with pseudoseizures to an emergency department.
  • The patient cohort included 50% teenagers, with a 70% female predominance.
  • None of the observed pseudoseizures involved incontinence or resulted in injury.

Findings:

  • A significant majority (90%) of patients underwent invasive diagnostic procedures or laboratory tests.
  • Anticonvulsant medications were administered to 60% of the patients, despite the absence of epilepsy.
  • Pseudoseizures were frequently confused with generalized tonic-clonic seizures by medical staff.

Implications:

  • The findings highlight a diagnostic challenge in pediatric emergency medicine, leading to potential overtreatment and unnecessary medical interventions.
  • Improved diagnostic criteria and physician education are needed to reduce misdiagnosis rates of pseudoseizures.
  • Accurate diagnosis of pseudoseizures can prevent iatrogenic harm and optimize the use of healthcare resources.

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