Diagnosis, management and prognosis of a group of 128 patients with non-epileptic attack disorder. Part I

Seizure. 1992 Mar;1(1):19-26. doi: 10.1016/1059-1311(92)90050-b.

Abstract

Three hundred and forty three patients with attack disorder labelled as epilepsy were admitted for assessment to a Neuropsychiatry ward in a small English mental hospital over a 5 year period. After assessment it was decided that 63% (215) of these patients had epilepsy, but in 128 (37%) a diagnosis of non-epileptic seizures was made. Just over a third of these patients (46) had an additional history of present or past epileptic seizures as well, so that 24% of the total population had non-epileptic seizures only. The methods used to make this diagnosis are reviewed and an attempt made to classify the non-epileptic attacks from which the patients were suffering. A variety of management strategies were offered and at discharge from hospital the majority of patients had practically lost their non-epileptic seizures. At follow-up 2 years later, seizures had returned in most patients. In 8% of the patients it was clear that the diagnosis of non-epilepsy had been erroneous. The importance of classifying the kind of non-epileptic event the patient suffers from and of translating treatment in hospital to the community is emphasized.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adult
  • Anxiety Disorders / diagnosis
  • Diagnosis, Differential
  • Electroencephalography
  • Epilepsy / diagnosis*
  • Epilepsy / therapy
  • Factitious Disorders / diagnosis
  • Female
  • Humans
  • Hysteria / diagnosis
  • Male
  • Middle Aged
  • Prognosis
  • Psychophysiologic Disorders / diagnosis
  • Psychotherapy
  • Relaxation Therapy