Document Detail


Psychogenic seizures: a focused clinical review for the emergency medicine practitioner.
MedLine Citation:
PMID:  20107287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Psychogenic seizures sometimes mimic neurogenic seizures and may occur concomitantly. Unlike neurogenic seizures, psychogenic seizures do not have abnormal electrical discharges on electroencephalogram, and their presence generally reflects an underlying psychiatric disorder. No single clinical observation can definitively distinguish psychogenic from neurogenic seizures. Evidence in support of the diagnosis includes asynchronous extremity movements, rapid turning of the head from side to side, forward pelvic thrusting, out-of-phase limb movements, presence of a light reflex, and geotropic eye movements. Video electroencephalogram monitoring is a particularly valuable method of distinguishing psychogenic from neurogenic seizures. When the diagnosis is suspected by history, physical examination, maneuvers, and laboratory tests, and after the proper stabilization steps have been taken, the emergency medicine practitioner should consult a neurologist and a psychiatrist to assist in the patient's further evaluation and management. Although the diagnosis of psychogenic seizures cannot always be secured in the emergency department, identifying patients with this condition is important because it can obviate unnecessary pharmacologic interventions and help patients obtain proper psychiatric care.
Authors:
Peter D Panagos; Roland C Merchant; Robert L Alunday
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Postgraduate medicine     Volume:  122     ISSN:  1941-9260     ISO Abbreviation:  Postgrad Med     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-28     Completed Date:  2010-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401147     Medline TA:  Postgrad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  34-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI 02903, USA. panagosp@wusm.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Diagnosis, Differential
Electroencephalography
Emergency Medicine
Humans
Mental Disorders / complications*
Risk Factors
Seizures / diagnosis*,  etiology*,  physiopathology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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