title: Pseudoseizures and asthma.
abstract: BACKGROUND
  Sexual abuse and head injury are important risk factors of pseudoseizures, reported in about a third of patients. Clinical experience suggests that asthma is another possible risk factor.
  
  
  OBJECTIVE
  To determine the relative prevalence of asthma in patients with pseudoseizures.
  
  
  METHODS
  A retrospective record review was undertaken of reported asthma in 102 patients with pseudoseizures and 70 psychotic controls. The pseudoseizure patients were subgrouped according to method of diagnosis: 47 in whom epilepsy was excluded by capturing a typical attack on video-electroencephalographic monitoring (VEEM), and 55 not diagnostically confirmed with VEEM.
  
  
  RESULTS
  Asthma was reported in 26.5% of pseudoseizure patients, compared with 8.6% of the psychotic controls (chi(2) = 8.6; p = 0.003). Asthma was reported at similar rates in the VEEM confirmed (29.8%) and non-VEEM confirmed (23.6%) pseudoseizure subgroups. The significant excess of reported asthma held for both the VEEM confirmed subjects (Pearson's chi(2) = 5.4, p = 0.02) and non-VEEM confirmed subjects (Pearson's chi(2) = 8.9, p = 0.003).
  
  
  CONCLUSIONS
  There is an association between pseudoseizures and reported asthma. Various models are proposed whereby somatisation, anxiety hyperventilation, and dissociative elaboration may account for the observed association. Both asthma and anxiety hyperventilation may be important risk factors for the development of pseudoseizures. The reported asthma may itself be psychogenic in origin in a proportion of patients. Confirmatory prospective studies are indicated.
authors.affiliation: National Neuropsychiatry Unit, Maudsley Hospital, London SE5, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: de Wet
authors.forename: J D C
authors.initials: JD
authors.lastname: Mellers
authors.forename: W N
authors.initials: WN
authors.lastname: Gardner
authors.forename: B K
authors.initials: BK
authors.lastname: Toone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D012720:Severity of Illness Index