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Pseudoseizure "status"

T Rechlin¹, T H Loew, P Joraschky

¹Department of Psychosomatics and Psychiatry, University of Erlangen-Nürnberg, Germany.

Journal of Psychosomatic Research

|May 1, 1997

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Pseudoseizure status, a conversion disorder, often co-occurs with severe mood disorders and impulse control issues. This study highlights the complex psychiatric comorbidities in patients experiencing pseudoseizure status.

Area of Science:

Neurology
Psychiatry
Psychosomatic Medicine

Background:

Conversion symptoms, including psychogenic seizures, are common in neurology.
Pseudoseizure status presents a diagnostic challenge, often overlapping with other psychiatric conditions.

Purpose of the Study:

To analyze the clinical characteristics and psychiatric comorbidities of patients diagnosed with pseudoseizure status.
To investigate the prevalence of specific psychiatric disorders in this patient group.

Main Methods:

Retrospective analysis of 18 patients diagnosed with pseudoseizure status.
Assessment of psychiatric comorbidities based on DSM-III-R criteria, including mood disorders, eating disorders, substance abuse, and personality disorders.

Main Results:

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All patients met criteria for conversion disorder.
High rates of comorbid major depression (5/18), bulimia nervosa (6/18), and substance abuse (7/18) were observed.
Significant prevalence of personality disorders, including borderline (10/18), antisocial (2/18), and histrionic (3/18), was noted. The majority had a history of self-harm or suicide attempts.

Conclusions:

Pseudoseizure status is frequently associated with severe affective imbalances and impaired impulse control.
Comprehensive psychiatric evaluation is crucial for managing patients with pseudoseizure status due to complex comorbidities.