Summary
The natural history and the outcome of psychogenic seizures was studied in 50 patients by retrospective analysis and follow-up after a mean of 2 years. Concomitant epilepsy was definite in only 8% and possible in 14%, while 50% took anticonvulsants. Overall, 66% of patients showed heterogeneous psychiatric abnormalities, most commonly a depressive syndrome (24%), whereas hysterical personality features were rare (8%). Forty-two percent of patients were unemployed. Follow-up of 41 patients (82%) showed that 34% had become seizure free. Outcome was poor in those with a long history of psychogenic seizures and pathological psychiatric findings. In contrast, almost all patients with recent onset of psychogenic seizures and normal psychological status had become seizure free. At follow-up, 56% of patients were found to be in a poor or very poor state, which resulted from a combination of physical, psychic and social problems in most cases.
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References
American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. APA, Washington, DC
Chodoff P, Lyons H (1958) Hysteria, the hysterical personality, and “hysterical” conversion. Am J Psychiatry 114:734–740
Cohen RJ, Suter C (1982) Hysterical seizures: suggestion as a provocative EEG test. Ann Neurol 11:391–395
Desai BT, Porter RJ, Penry K (1982) Psychogenic seizures. Arch Neurol 39:202–209
Gates JR, Ramani V, Whalen S, Loewenson R (1985) Ictal characteristics of pseudoseizures. Arch Neurol 42:1183–1187
Gubermann A (1982) Psychogenic pseudoseizures in non-epileptic patients. Can J Psychiatry 27:401–404
Gullick TA, Spinks IP, King DW (1982) Pseudoseizures: ictal phenomena. Neurology 32:24–30
Kanner A, Morris HH, Dinner DS, Lüders H, Wyllie E, Kramer R, Rowan AJ (1988) Supplementary motor seizures mimicking pseudoseizures: how to distinguish one from the other. Neurology 1988:347
Krumholz A, Niedermeyer E (1983) Psychogenic seizures. A clinical study with follow-up data. Neurology 33:498–502
Lesser RP (1985) Psychogenic seizures. In: Pedley TA, Meldrum BS (eds.) Recent advances in epilepsy. Churchill Livingstone, Edinburgh, pp 273–296
Lesser RP, Lueders H, Dinner DS (1983) Evidence for epilepsy is rare in patients with psychogenic seizures. Neurology 33:502–504
Ljungberg L (1957) Hysteria: a clinical, prognostic and genetic study. Acta Psychiatr Neurol Scand [Suppl]. 112:1–162
Luther JS, McNamara JO, Carwile S, Miller P, Hope V (1982) Pseudoepileptic seizures: methods and video analysis to aid diagnosis. Ann Neurol 12:458–462
McKegney FP (1967) The incidence and characteristics of patients with conversion reactions: a general hospital consultation service sample. Am J Psychiatry 124:542–545
Merskey H, Buhrich NA (1975) Hysteria and organic brain disease. Br J Med Psychol 48:359–366
Ramani V (1986) Intensive monitoring of psychogenic seizures, aggression and dyscontrol syndromes. In: Gumnit RJ (ed) Advances in neurology, vol 46. Intensive neurodiagnostic monitoring. Raven Press, New York, pp 203–217
Ramani V, Gumnit RJ (1982) Management of hysterical seizures in epileptic patients. Arch Neurol 39:78–81
Stefánsson JG, Messina JA, Meyerowitz S (1976) Hysterical neurosis, conversion type: clinical and epidemiological considerations. Acta Psychiatr Scand 53:119–138
Stewart RS, Lovitt R, Stewart M (1982) Are hysterical seizures more than hysteria? A research diagnostic criteria, DSM III, and psychometric analysis. Am J Psychiatry 139:926–928
Williams DT, Gold AP, Shront P, Shaffer D, Adams D (1979) The impact of psychiatric intervention on patients with uncontrolled seizures. J Nerv Ment Dis 167:626–631
Ziegler FJ, Imboden JB, Meyer E (1960) Contemporary conversion reactions: a clinical study. Am J Psychiatry 116:901–910
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Lempert, T., Schmidt, D. Natural history and outcome of psychogenic seizures: a clinical study in 50 patients. J Neurol 237, 35–38 (1990). https://doi.org/10.1007/BF00319665
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DOI: https://doi.org/10.1007/BF00319665