[Non-epileptic crisis: which therapeutic strategy to follow?].
About 20% of patients with intractable epilepsy do not have epileptic seizures. The exact diagnosis is in fact difficult because most of the time, the seizures are not directly visualized. In case of uncertainty, prolonged EEG/Video monitoring and clinical observation are necessary to avoid escalated drug therapy and behavioural problems. We describe two such cases. The diagnosis of non epileptic attacks was told to the patients, the antiepileptic drugs were progressively withdrawn and an intensive psychotherapy was started. The seizures decreased in number and severity. In both cases, sexual abuse in childhood was discovered.
Lamiral
B
B
Centre Neurologique William Lennox, Ottignies.
Van Rijckevorsel-Harmant
K
K
D000328:Adult; D002650:Child Abuse, Sexual; D002675:Child, Preschool; D003291:Conversion Disorder / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007179:Incest; D011613:Psychotherapy / Q000379:methods; D012640:Seizures / Q000175:diagnosis / Q000523:psychology*; D012652:Self Mutilation; D014741:Video Recording
Crises non épileptiques: quelle stratégie thérapeutique?