title: Saline infusion: a diagnostic and therapeutic tool in nonepileptic attacks?
abstract: OBJECTIVE
  Nonepileptic attacks (NEAs) pose diagnostic and therapeutic uncertainties. Prognosis is poor. Activation procedures like saline infusion have been used for diagnostic purposes.
  
  
  METHODS
  We reviewed 66 consecutive patients with a probable diagnosis of NEA. During the EEG an attempt was made to induce an attack with verbal suggestion and saline infusion. Patients were followed up with a postal or telephone questionnaire 4.5 years after the EEG.
  
  
  RESULTS
  Saline infusion with verbal suggestion induced in 41 of 66 patients a NEA, i.e., a positive test. Thirty-one patients were followed up. Attacks were reduced in 20 patients, of whom 12 were attack-free. More patients were attack-free at follow-up after a positive (7 of 16) in comparison to a negative (5 of 15) test.
  
  
  CONCLUSIONS
  A provocative test can be diagnostic in some patients with NEA. An early and firm diagnosis may lead to appropriate treatment and better outcome.
authors.affiliation: Department of Neurology, University of Berne, Inselspital, CH-3010 Berne, Switzerland. e.wassmer@totalise.co.uk
authors.forename: E
authors.initials: E
authors.lastname: Wassmer
authors.forename: S R
authors.initials: SR
authors.lastname: Wassmer
authors.forename: F
authors.initials: F
authors.lastname: Donati
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012640:Seizures / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy*; D012965:Sodium Chloride / Q000627:therapeutic use*; D013268:Stimulation, Chemical; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D012965:Sodium Chloride