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Behavioural Neurology
Volume 3 (1990), Issue 3, Pages 133-141
http://dx.doi.org/10.3233/BEN-1990-3301

Convulsive Pseudoseizures: A Review of Current Concepts

Ghislaine Savard1,2 and Frederick Andermann1

1Department of Neurology and Neurosurgery, McGill University, and The Montreal Neurological Institute and Hospital, Canada, USA
2Montreal Neurological Hospital, 3801 University Street, Montreal, Que. H3A 2B4 Canada, USA

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Convulsive pseudoseizures thought to represent psychiatric disease can usually be detected early if they are considered in the epileptologist's differential diagnosis. No single diagnostic criterion for this behavioural disorder is known to be pathognomonic. Epilepsy and all physiological explanations have to be thoroughly ruled out and positive evidence of relevant psychopathology has to be gathered. The presence of pseudo seizures often heralds severe psychopathology, most frequently major affective disorder and major personality disorder, and occasionally, factitious disorder. Pseudoseizures can coexist with epileptic seizures and are often triggered by anticonvulsant toxicity. Diagnostic problems are more likely to be encountered in patients with frontal or parietal epilepsies, and in patients whose severe psychopathology is refractory to psychiatric intervention.