Diagnosis of hysterical seizures in epileptic patients

Abstract

The coexistence of epileptic and hysterical seizures in the same patient is not rare and creates problems in diagnosis and management. Simultaneous video-EEG monitoring was used to document the diagnosis of hysterical seizures in 9 epileptic patients; clear-cut hysterical seizures were seen in all 9. Individualized re-educative psychotherapy was used to teach patients alternative coping techniques and discharged them on minimum dosages of anticonvulsants. None of the patients had a classical hysterical personality, which suggests that conversion reaction is a more appropriate diagnosis. The etiology of hysterical seizures varies; individualized treatment and long-term follow-up was emphasized.