PSEUDOSEIZURES: DIAGNOSTIC GUIDELINES
Apply very loosely as the true spectrum of all the seizure types
within real epilepsy is enormous.
CLINICAL FEATURES HYSTERICAL EPILEPSY
EEG:ictal/interictal normal abnl/variable
Duration variable short, same
Pattern variable stereotyped
Frequency variable paroxsymal,cluster
Cause emotional organic
Place home anywhere
Presence of others yes variable
During sleep rare yes
Presence of aura variable variable
Onset gradual sudden
Incontinence rare infrequent
Biting lips tongue/cheek
Scream during spell at onset
Convulsion bizarre, thrashing tonic/clonic
sexual movements
Injury infrequent,mild infrequent,severe
frequent,minor
Pupillary reflex normal slow,non-reactive
Babinski no yes if convulsion
Memory of seizure variable usually amnestic
Orientation afterwards clear confused
Effect of suggestion precipitate or no effect
terminate
Postictal stupor rare frequent
Memory of past szs yes no
under hypnosis
Hypnotizability high average
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Reference List
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