Saline infusion: a diagnostic and therapeutic tool in nonepileptic attacks?
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.
Wassmer
E
E
Department of Neurology, University of Berne, Inselspital, CH-3010 Berne, Switzerland. e.wassmer@totalise.co.uk
Wassmer
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SR
Donati
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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
D012965:Sodium Chloride