Seizure suggestibility may not be an exclusive differential indicator between psychogenic and partial complex seizures: the presence of a third factor.
Differential diagnosis between psychogenic or ('hysterical') pseudoseizures and clinical partial complex seizures has often employed an index or inference of suggestibility. However, recent research indicates a moderate association between complex partial epileptic-like signs and hypnotic capacity in the normal population as well as for complex partial epileptic patients. Consequently, the precipitation of overt, non-stereotyped seizures by instruction may not be a reliable diagnostic method when an insidious process is slowly elevating temporal/limbic lobe lability. Implications for treatment and contra-indication of antipsychotic (D2 antagonist) drugs are discussed.
Persinger
M A
MA
Clinical Neuroscience Laboratory, Laurentian University, Sudbury, Ontario, Canada.
D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects; D003291:Conversion Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D003937:Diagnosis, Differential; D065127:Dopamine D2 Receptor Antagonists; D004569:Electroencephalography / Q000187:drug effects; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D004830:Epilepsy, Tonic-Clonic / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D006990:Hypnosis; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D013404:Suggestion
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D065127:Dopamine D2 Receptor Antagonists