Provocation of nonepileptic seizures by suggestion in a general seizure population.
Nonepileptic seizures (NES) are common and are often diagnosed at epilepsy centers by video-EEG recording of both spontaneous and suggestion-induced episodes, but no study has evaluated provocative testing in a general seizure population. We studied consecutive patients with a tentative diagnosis of epilepsy using saline provocation during video-EEG recording, suggesting that this could produce a typical seizure. Of 52 patients, 40% had no response, 23% had responses unlike their seizures, and 37% had typical episodes (positive test). Patients whose usual episodes resembled complex partial seizures (CPS) were more likely to have NES than were patients with a history of generalized tonic-clonic seizures (GTC). Of patients with positive provocations, the primary physician predicted NES in 68% of cases. This preliminary study suggests that NES are frequent in a general neurology setting, and that saline provocation is a sensitive method of identifying NES.
Bazil
C W
CW
New York University Medical Center, New York.
Kothari
M
M
Luciano
D
D
Moroney
J
J
Song
S
S
Vasquez
B
B
Weinreb
H J
HJ
Devinsky
O
O
D000328:Adult; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis; D017029:Epilepsy, Complex Partial / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D011602:Psychophysiologic Disorders / Q000175:diagnosis*; D012640:Seizures / Q000175:diagnosis*; D012965:Sodium Chloride; D013404:Suggestion; D014743:Videotape Recording
D012965:Sodium Chloride