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Psychogenic non-epileptic seizures as a frequent diagnostic problem
Abstract
Introduction: Psychogenic non-epileptic seizures represent a paroxysmal event followed by a sudden change of behavior, cognition or consciousness, mostly of short duration, which resemble or can be understood as epileptic seizures. They occur in persons without epilepsy and in patients with epilepsy. They are not associated with abnormal EEG discharges because their cause is a psychic disorder. Case report: A 20-year-old patient has been suffering of occasional “morning short-lasting jerking hand movements, staring and fainting” since the age of 14 years. Beside a symptomatic anamnesis for epilepsy and non-specifically changed standard EEG, antiepileptic therapy (valproate and lamotrigine) was introduced. Because of non-response to antiepileptic therapy, the patient was forwarded for further clinical examination involving video EEG telemetry, which indicated that this was a case of psychogenic non-epileptic seizures. A successive withdrawal of antiepileptic drugs was initiated, and also, a psychologist and psychiatrist were included into treatment, which resulted in the reduction of seizures and improvement of the patient's general condition. Conclusion: Psychogenic non-epileptic seizures represent a frequent diagnostic problem requiring team's work, while the video EEG telemetry is the method of choice for diagnosis.
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