Psychogenic seizures: A review and description of pitfalls in their acute diagnosis and management in the emergency department.
Patients with psychogenic (nonepileptic) seizures (PS) are frequently encountered by clinicians in the emergency medicine setting. Despite the tendency for these patients to seek frequent medical attention, the time between onset of symptoms and diagnosis is often more than 7 years. The cause of PS is multifactorial, but most patients are thought to have an underlying dissociative condition. The diagnostic evaluation in the emergency department is challenging and relies heavily on clinical suspicion, based on historical and physical features. Laboratory testing and therapeutic maneuvers are of limited utility; prolonged video electroencephalography is the diagnostic gold standard. Once the diagnosis has been secured, the mainstay of treatment involves addressing the underlying psychological distress.
Department of Emergency Medicine, Rhode Island Hospital, Alpert Medical School of Brown University, 593 Eddy Street, Claverick Building, Providence, RI 02903, USA.
Matthew S
MS
Siket
Roland C
RC
Merchant
D000208:Acute Disease; D003291:Conversion Disorder / Q000175:diagnosis*; D004213:Dissociative Disorders / Q000175:diagnosis; D004569:Electroencephalography; D004636:Emergency Service, Hospital; D006801:Humans; D010808:Physical Examination; D012017:Referral and Consultation; D012640:Seizures / Q000175:diagnosis* / Q000523:psychology