For those who have or know about pseudoseizures

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I have had physiological (ie. not psychogenic) seizures for 6 months, but a 12-year old neighbor of mine who, ah, sees me as role-model (don't ask me why - lol) has suddenly developed psychogenic seizures. It's so obvious it's really sad, and a pediatric neurologist said as much as well. I haven't had any in front of her, however it doesn't take much to see what seizures look like on the internet these days. Under the guidance of the neurologist, her parents and I are working with her on this, and right now the parents are using the "well anyone who has seizures can't do that" approach (play video games, stay up late, swim, eat junk food, you name it). Their next approach is to give her an "AED" (placebo). Anyway, her situation with pseudoseizures has led to questions I have that I would like the folks here who also have pseudoseizures (or know about them) to answer: 1. Do pseudoseizures have a stereotypical pattern of aura, seizure activity, seizure after-effects, etc.? Or, are the seizure-related behaviours for a given seizure type more variable than for physiological seizures? 2. Do pseudoseizures even have aura, and seizure after effects like headache, electrical sensations, etc.? 3. Are AEDs helpful for pseudoseizures? Can one "convince" themselves (consciously or subconsciously) that a particular AED is working, and therefore the seizures seem to come under at least partial control? Or, is the psychological reason for having the seizures too strong for any AED to work? 4. Since very often EEGs, MRIs, etc. can be normal even in those with physiological seizures, how does a neurologist determine that someone is in fact having pseudoseizures (assuming no obvious issues like pre-diagnosed mental disorder, mental or physical trauma, severe stress, etc,)? Thank you in advance for your help!

Comments

Re: For those who have or know about pseudoseizures

Submitted by zealot on Sun, 2010-11-07 - 09:30

stm,

It's nice to see you here. Yours is a good post. I personally think PNES is a crock, but that doesn't mean that I don't believe that their are non-epileptic seizures. By definition, there are.

There is a huge problem here. Epilepsy is a chronic condition. Seizures are acute events. Trying to use the same word for both is a ridiculous and dangerous exercise with disastrous and deadly consequences.

Just because a seizure is not epilepitic, doesn't mean it is psychogenic. There are many and various types of non-epileptic seizures.
Just because epileptiform activity is not recorded, doesn't mean the seizure wasn't epileptic. Deep brain seizures can't be recorded via surface electrodes.
EEGs are administered and read by humans. Humans make mistakes.
An EEG is not necessary for a diagnosis of epilepsy.
A negative EEG is not a rule out for epilepsy.
Lack of response to AEDs is not a rule out for epilepsy. I was slightly responsive to Valproic Acid (Depakene). I was slightly responsive to Gabapentin (Neurontin). I was not responsive to a long list. I was quite responsive to Oxcarbazepine (Trileptal) and Carbamazepine (Tegretol). I am surviving on 500mgs Q6 hours of two 250mg tablets of Teva Brand Levitiracetam (Keppra). I woke up before my alarm this morning from a seizure. It was nasty. Just because I'm still having seizures doesn't mean the Keppra isn't working. I'd be in status without it.
Etc. I'm too upset for more of this.

PNES, whatever it may be, is just as real as epilepsy. It is a neurophysiological phenomonon or, more likely, phenomona, that have been dumped into a Psycho Neurologists' garbage can diagnosis called pseudoseizures. It is a real condition.

All "Mental Illness" has an organic basis. The stinks (shrinks, psychiatrists, stynchiatrists) don't want us to know this because "I'm not a Medical Doctor." What the hell does M.D. stand for?

It's all a power grab with patients paying the price.

The compassion you have for your friend does not surprise me. You are a good person. Thank you for this post.

I have suffered terribly from having my neurological symptoms dismissed by parents, teachers, and doctors alike. I am brain damaged and extremely ill from the combination of abuse and neglect to which I have been subjected.

I am not bitter. I am hurt. I am angry. I am afraid. I want to live. I want to live well. No one can or will give me what I need to do that.

Baruch Hashem. Hoshia na.

Devorah Zealot Soodak http://psychout.typepad.com/ the zealot needs help! Please read my blog. Thanks.

P.S. A nice post from the zeelot.

P.P.S. The newest post from the zeelot.

P.P.P.S. The newest reblog from the zeelot.

stm, It's nice to see you here.  Yours is a good post.  I personally think PNES is a crock, but that doesn't mean that I don't believe that their are non-epileptic seizures.  By definition, there are. There is a huge problem here.  Epilepsy is a chronic condition.  Seizures are acute events.  Trying to use the same word for both is a ridiculous and dangerous exercise with disastrous and deadly consequences. <ol> <li>Just because a seizure is not epilepitic, doesn't mean it is psychogenic.  There are many and various types of non-epileptic seizures.</li> <li>Just because epileptiform activity is not recorded, doesn't mean the seizure wasn't epileptic.  Deep brain seizures can't be recorded via surface electrodes.</li> <li>EEGs are administered and read by humans.  Humans make mistakes.</li> <li>An EEG is not necessary for a diagnosis of epilepsy.</li> <li>A negative EEG is not a rule out for epilepsy.</li> <li>Lack of response to AEDs is not a rule out for epilepsy.  I was slightly responsive to Valproic Acid (Depakene).  I was slightly responsive to Gabapentin (Neurontin).  I was not responsive to a long list.  I was quite responsive to Oxcarbazepine (Trileptal) and Carbamazepine (Tegretol).  I am surviving on 500mgs Q6 hours of two 250mg tablets of Teva Brand Levitiracetam (Keppra).  I woke up before my alarm this morning from a seizure.  It was nasty.  Just because I'm still having seizures doesn't mean the Keppra isn't working.  I'd be in status without it.</li> <li>Etc.  I'm too upset for more of this.</li> </ol> PNES, whatever it may be, is just as real as epilepsy.  It is a neurophysiological phenomonon or, more likely, phenomona, that have been dumped into a Psycho Neurologists' garbage can diagnosis called pseudoseizures.  It is a real condition.  All "Mental Illness" has an organic basis.  The stinks (shrinks, psychiatrists, stynchiatrists) don't want us to know this because "I'm not a Medical Doctor."  What the hell does M.D. stand for? It's all a power grab with patients paying the price. The compassion you have for your friend does not surprise me.  You are a good person.  Thank you for this post. I have suffered terribly from having my neurological symptoms dismissed by parents, teachers, and doctors alike.  I am brain damaged and extremely ill from the combination of abuse and neglect to which I have been subjected. I am not bitter.  I am hurt.  I am angry.  I am afraid.  I want to live.  I want to live well.  No one can or will give me what I need to do that. Baruch Hashem.  Hoshia na. Devorah Zealot Soodak http://psychout.typepad.com/ the zealot needs help! Please read my <a href="http://psychout.typepad.com/">blog</a>. Thanks. <a href="http://psychout.typepad.com/blog/2010/10/epilepsy_google_health_mayo_clinic_medline_plus_webmd_www_epilepsy_com_en_wikipedia_org_wiki_epilepsy_www_epilepyfoundation_o.html">P.S. A nice post from the zeelot.</a> <a href="http://psychout.typepad.com/blog/2010/11/temporal-lobe-epilepsy-seizures-devorah-zealot-soodak-nee-deborah-ellen-soodak-aka-debbie-soodak.html">P.P.S. The newest post from the zeelot.</a> <a href="http://psychout.typepad.com/blog/2010/11/americans-with-epilepsy-feel-lucky-and-privileged-epilepsycom.html">P.P.P.S. The newest reblog from the zeelot.</a>  