Treatment approach in a child with hysterical seizures superimposed on partial complex seizures.
This article reports the case of a 9 1/2 year old child with a history of psychomotor epilepsy which was uncontrolled by multiple anticonvulsant medications. When admitted to the psychiatric inpatient service, he was treated with a combination of pharmacological, behavioural and psychodynamically oriented approaches. A period of intensive family counseling was conducted to clarify the parents' concerns about causality of the seizures and methods for dealing with them. This combined approach led to a complete cessation of reported seizures and a decreased number and dosage of anticonvulsant medications. The authors discuss the reluctance of some physicians to accept the co-existence of neurogenic and psychogenic seizures in a given patient. Patients with pharmacologically uncontrolled seizures must be identified and accurately diagnosed (neurogenic and/or psychogenic) to prevent complication such as over-medication and to administer appropriate treatment. Multiple disciplinary therapy including psychodynamic, pharmacological, behavioural and educational approaches should be implemented.
D000927:Anticonvulsants / Q000008:administration & dosage; D001521:Behavior Therapy; D002648:Child; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000628:therapy; D006801:Humans; D007046:Hysteria / Q000150:complications*; D008297:Male; D010290:Parents / Q000523:psychology; D012640:Seizures / Q000209:etiology* / Q000628:therapy; D013070:Speech Therapy
D000927:Anticonvulsants