[Induction of pseudoseizures by placing inactive electrodes in the malar regions].
BACKGROUND
Pseudoseizures are paroxysmal disorders of a psychogenic origin with manifestations that are similar to epileptic seizures. They constitute a pathology that is found relatively often in the clinical practice of neurology. In many cases the diagnostic suspicion of their existence is difficult to confirm. The complementary examination that proves to be most useful in diagnosing them is video electroencephalogram (video-EEG).


METHODS
We report the cases of seven patients who were referred to our service with a clinical suspicion of pseudoseizures. Placing electrodes with an inactive surface-coating over the two malar regions during a video-EEG study enabled us to trigger in all patients (by means of suggestion) the appearance of a clinical picture that was similar to those that initially gave rise to the request for an examination. Suggestion was also employed to limit the time they lasted by getting the patient to resolve the episode. In all the cases the trace of the simultaneous electroencephalogram showed no pathological findings.


CONCLUSIONS
Placing inactive electrodes on malar regions is a method for inducing pseudoseizures that is harmless, easily applicable, readily available and economical, and which has not been reported in the literature. Video-EEG monitoring time is reduced using this approach. It provides evidence that a specific seizure phenomenon can be induced and resolved by suggestion techniques, which is a fact that is very useful in the diagnosis of pseudoseizures.
Cano-Plasencia
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R
Servicio de Neurofisiología Clínica, Hospital San Pedro de Alcántara, E-10005 Cáceres, Spain. ricanopia@hotmail.com
Gómez-Marcos
A M
AM
Cano-Sánchez
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002610:Cheek; D015897:Comorbidity; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004566:Electrodes; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications / Q000175:diagnosis*; D017029:Epilepsy, Complex Partial / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D014741:Video Recording