Psychogenic pseudo-epileptic seizures is evidence that not every disorder that presents itself as a seizure is actually epilepsy. Disorders that appear in the form of seizures may be associated with both metabolic dysfunctions and problems with the functioning of the patient's psyche. It is the latter factor that is associated with psychogenic pseudo-epileptic seizures.

Psychogenic pseudo-epileptic seizuresare somatic symptoms that are induced by mental disorders. The occurrence of somatic diseases and the mental state of people are closely related. Disturbances in the functioning of the psyche may worsen the course of various organic diseases (such a situation may occur, for example, in a patient with diabetes who is also depressed). The problem in the case of the psychological background of the patient's symptoms is that the clinical picture of the disorder is often difficult to distinguish from that of problems caused by organic factors. In the case of psychogenic pseudo-epileptic seizures, the wrong diagnosis is relatively frequent. This is related to the frequency of the disorder - it turns out that up to 20% of patients with seizures with a theoretically characteristic course of epilepsy do not actually suffer from epilepsy, but from psychogenic pseudo-epileptic seizures. The disorder is more common in women and its onset is most often in adolescence and early adulthood.

Psychogenic pseudo-epileptic seizures: causes

A specific factor that could be considered a cause of psychogenic seizures has not yet been discovered. It is believed that this problem belongs to the group of dissociative disorders. They appear as a result of experiencing extremely difficult, traumatic events. Dissociative disorders occur when emotions are suppressed by the patient - the effect of such suppression is to "replace" the emotional conflict with the appearance of somatic ailments. One of the possible symptoms in such a situation are psychogenic pseudo-epileptic seizures. The basis for psychogenic pseudo-epileptic seizures may be found in the patient's experience of such events as:

  • abusesexual in childhood
  • divorce
  • death of a loved one
  • involved in a traffic accident
  • being in a pathological relationship
  • growing up in a dysfunctional family (where, for example, parents were addicted to alcohol)
  • being a victim of mixed background persecution

Psychogenic pseudo-epileptic seizures: symptoms

Psychogenic pseudo-epileptic seizures resemble disorders that occur during tonic-clonic seizures. As with a typical epilepsy attack, patients may experience amnesia regarding the period of onset of the disorder. There are, however, some differences that make it possible to distinguish a psychogenic seizure from the actual seizure. The phenomena that are characteristic of psychogenic pseudo-epileptic seizures are:

  • variability in the frequency of seizures
  • seizures lasting more than two minutes
  • the patient's eyes are closed during a seizure
  • the disorders appear gradually and slowly (patients may even signal that they are about to have a seizure)
  • the tongue is rarely bitten, and if it does, the wound usually appears at the tip of the tongue
  • there is no involuntary urination during a seizure
  • there are many seizures, up to 30 of them appear daily
  • seizures usually occur in the presence of other people
  • during the seizure the patient intensely moves his head from side to side

The above-mentioned features do not allow to classify the disorders appearing in the patient as pseudo-epileptic seizures, because they can also occur in the case of epilepsy. It is possible to make a diagnosis by combining the clinical picture with the performance of specialist examinations.

Psychogenic pseudo-epileptic seizures: recognizing

The electroencephalographic (EEG) examination and the observation of the patient's behavior during the seizure are of fundamental importance in the diagnosis of psychogenic pseudo-epileptic seizures. In the diagnosis of disorders, use is made of monitoring the patient with EEG with simultaneous registration of the seizure. A characteristic feature of psychogenic pseudo-epileptic seizures is that during their onset, no disturbances in the brain's electrical activity are detected in the EEG (but they occur in typical cases of epilepsy). In addition, in classic epilepsy, after the seizure, the EEG shows a decrease in the electrical activity of the brain, in the case of psychogenic seizures, no deviations are also observed inObservation of the behavior of patients during a seizure is particularly important as it also allows to confirm or exclude the psychological basis of the seizures that occur. The neurologist observing the patient during the seizure may try to open the patient's (usually closed) eyes - this is usually met with the patient's resistance and inability to do so. The physician may also carefully lift the patient's upper limb above his face and then release it - in the case of psychogenic pseudo-epileptic seizures, the patient's hand will usually not reach the face and will be stopped a few centimeters in front of it. . Typically, patients struggling with this problem used many different antiepileptic drugs, which - due to the psychological basis of the disease - did not bring the expected improvement in the condition of patients in the form of reducing the frequency of seizures. The suspicion of psychogenic pseudo-epileptic seizures does not make it possible to abandon the extended diagnosis of the patient. Other possible causes of seizures should be ruled out. For this purpose, imaging tests are performed, as well as laboratory tests (seizures may be associated with metabolic disorders, e.g. diabetes, which is why the diagnostic process uses e.g. blood glucose measurements). neurological examinations must be performed in every patient with psychogenic pseudo-epileptic seizures is that the problem may coexist with classic epilepsy.

Psychogenic pseudo-epileptic seizures: treatment

Due to the fact that psychogenic disorders are the cause of psychogenic pseudo-epileptic seizures, it is precisely their solution that constitutes the basis for therapeutic interventions. Various techniques of psychotherapy are used, e.g. cognitive-behavioral psychotherapy and group psychotherapy. Often, before the diagnosis is made in a patient - suspected of suffering from epilepsy - treatment with antiepileptic agents is initiated. In such a situation, it is necessary to gradually, slowly discontinue these drugs and be under the constant care of a neurologist during this time.

Psychogenic pseudo-epileptic seizures: prognosis

The prognosis of patients with psychogenic seizures depends mainly on the duration of the disorder. The greatest chance of recovery is when the problem is recognized and treated during adolescence. According to estimates, more than half of the patients who develop psychogenic seizurespseudo-epileptic diseases have been present for more than 10 years, they will struggle with them even despite the implementation of appropriate psychotherapy. This fact perfectly indicates that the treatment of psychogenic pseudo-epileptic seizures should be undertaken as soon as possible after the onset of disorders.

Category:

Neurology