a clinical spell that resembles an epileptic seizure, but is not due to epilepsy. The EEG is normal during an attack, and the behavior is often related to psychiatric disturbance, such as a conversion disorder.
psychogenic seizureA specific type of seizure regarded as a conversion symptom, which occurs when a person cannot directly express distress; patients are not consciously aware of the conversion symptoms, nor do they intentionally produce them. The seizures may be accompanied by somatic symptoms, which serve several purposes for the patient—e.g., communication, secondary gain, conflict resolution, expression of hostility and others.
Frequent seizures despite therapeutic levels of anti-epileptic medication, prolonged duration (more than 5 minutes), wild movements, pelvic thrusting, fluctuating intensity, resolution of symptoms with distraction, nonphysiologic spread of symptoms, crying, bilateral motor activity with preserved consciousness, lack of post-ictal confusion or lethargy.
• Good—if female, of higher intelligence, independent lifestyle, no prior psychotherapy, normal EEG.
• Poor—if accompanied by epilepsy or seizure activity, history of psychiatric disorders, unemployed.