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Abstract
Despite significant advances in epileptology, the differential diagnosis of epileptic and pseudoepileptic seizures continues to be a considerable challenge. The problem becomes even more complicated when epileptic and psychogenic pseudoepileptic seizures coexist in the same patient . Appropriate psychological measures may be helpful in the diagnosis and may improve knowledge about aetiological factors which can provoke psychogenic pseudoepileptic seizures. The purpose of this paper is to present the psychological profile of patients with mixed seizures (epileptic and psychogenic pseudoepileptic) developed on the basis of the Minnesota Multiphasic Personality Inventory (MMPI) and to discuss the personality differences between patients with psychogenic epileptic seizures and epileptic patients. In patients with diagnosed epilepsy and/or suspected psychogenic pseudoepileptic seizures long-term video-monitoring was performed. On the basis of the gathered data the patients were divided into three groups: group I (N= 32 : 25 F and 7 M) had coexistent psychogenic pseudoepileptic and epileptic seizures, group II (N= 38 : 30 F and 8 M) had psychogenic pseudoepileptic seizures only and group III (N= 36 : 18 F and 8 M) had epileptic seizures only and was treated as the control group. All three groups were given the MMPI. Comparison of the averaged personality profiles of the three groups revealed significant differences (P< 0.0001) in hypochondriasis (Hs) and hysteria (Hy), similarity of the profiles of groups I and II, and significantly higher Hs and Hy scores than D (Depression) scores (P< 0.001). Unlike groups I and II, group III (the epileptic group) had significantly higher D scores than Hs and Hy scores (P< 0.01). Our findings suggest that conversion, manifested in the typically elevated Hs and Hy scores as compared to D scores, is present in both groups of patients demonstrating pseudoepileptic seizures but absent in the patients with epilepsy where the Hs and Hy to D ratio is reversed. Patients with mixed seizures and patients with psychogenic pseudoepileptic seizures only have similarly shaped profiles.
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References
References
- Pseudoseizures: seizures that are not epilepsy.Lancet. 1990; 336: 163-164
- Ictal characteristic of pseudoseizures.Archives of Neurology. 1985; 42: 1183-1187
- Pseudoseizures versus pseudopseudoseizures.Epilepsia. 1993; 34 (Suppl. 2)
- Patients with psychogenic pseudoepileptic seizures.Epileptologia. 1994; 2: 11-24
- Behavioural mechanisms involved in pseudoepileptic seizures: a comparison between patients with epileptic seizures and patients with pseudoepileptic seizures.Seizure. 1997; 6: 275-282
- Psychogenic pseudoepileptic seizures: clinical and electroencephalogram (EEG) video-tape recordings.European Journal of Neurology. 1999; 32: 18-23
- Diagnosis, management and prognosis of a group of 128 patients with nonepileptic attack disorder. Part I.Seizure. 1992; 1: 19-26
- Panic disorder in seizure patients: a diagnostic pitfall.Epilepsia. 1991; 32: 33-38
- The diagnosis of psychogenic non-epileptic seizures: a review.Seizure. 1997; 6: 243-253
- Incidence of psychogenic seizures in adults: a population study in Iceland.Epilepsia. 1998; 39: 749-752
- Diagnosis of psychogenic pseudoepileptic seizures in the material of the Department of Neurology and Epileptology in Warsaw in 1990–1995.Epileptologia. 1996; 2: 133-138
- Differential MMPI performance in pseudo-seizure epileptic and pseudo-neurologic groups.Journal of Clinical Psychology. 1996; 22: 271-275
- Factors affecting the outcome of MMPI and neuropsychological assessments of psychogenic and epileptic seizure patients.Epilepsia. 1989; 30: 339-347
- Nonepileptic psychogenic seizures: quagmires of pathophysiology, diagnosis, and treatment.Epilepsia. 1998; 39: 458-462
- The MMPI as diagnostic tool in non-epileptic seizures.in: Rowan A.J Gates J.R Non-epileptic Seizures. Butterworth-Heinnemann, Boston1993: 101-110
- The MMPI-2 as an adjunct to the diagnosis of pseudoseizures.Seizure. 1996; 5: 35-40
- What is the significance of subjective events recording during long-term EEG video monitoring.Epilepsia. 1998; 39: 857-862
- Clinical profile of patients with epileptic and nonepileptic seizures.Neurology. 1996; 46: 1530-1533
- Psychogenic seizures.Epilepsia. 1986; 27 (Suppl. 2): 124-129
- Pseudoseizures (nonepileptic attack disorder)—clinical management and outcome in 50 patients.Seizure. 1993; 2: 141-146
- Non-epileptic Seizures. Butterworth-Heinemann, Boston1993
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