Psychiatric predictors of pseudoepileptic seizures in patients with refractory seizures.

This study compared psychiatric factors and diagnoses in patients with pseudoepileptic seizures and genuine seizures. A semistructured interview identified psychiatric diagnosis and the presence of psychiatric factors associated with conversion phenomena. Twenty-five subjects with medically refractory seizures were interviewed and followed prospectively until a definitive diagnosis of pseudoepileptic or genuine seizures was made by neurologists using video-EEG telemetry. Four factors help to identify patients with pseudoepileptic seizures: a psychiatric diagnosis of either somatization disorder or personality disorder, the presence of a childhood loss, or the presence of a model for seizure symptoms. These findings can aid clinicians in identifying patients who would benefit from referral to a video-EEG telemetry diagnostic unit.