title: Audio-induced psychogenic non-epileptic seizures.
abstract: A 45-year-old woman presented with vague attacks, which consisted of headaches, confusion and sleepiness. An electroencephalograph was normal, but subsequent scans revealed the presence of a right-sided convexity meningioma. This was excised and complications led to the removal of an infected bone flap in a separate procedure the following year. Various types of 'seizures' resulted from the operation. These were described to involve both tonic-clonic and absence seizures. This continued for 18 years, unaffected by medication, until a specialist diagnosed pseudo-epilepsy, by fortune of a hospital fire alarm. The patient began a psychological intervention programme including cognitive-behavioural therapy, which has significantly reduced episodes. In conclusion, psychogenic non-epileptic seizures may develop after intracranial neurosurgery undertaken for indications other than the control of refractory epileptic seizures. A diagnosis of psychogenic non-epileptic seizures should be considered in patients who develop refractory seizures after neurosurgery and managed appropriately.
authors.affiliation: School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 0SP, UK. ay276@cam.ac.uk
authors.forename: A M H
authors.initials: AM
authors.lastname: Young
authors.forename: T B
authors.initials: TB
authors.lastname: Stoker
mesh_terms: D001932:Brain Neoplasms / Q000150:complications / Q000523:psychology / Q000601:surgery*; D015928:Cognitive Behavioral Therapy; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D009622:Noise / Q000009:adverse effects*; D012640:Seizures / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome