USE OF INDUCTION PROCEDURES IN DIAGNOSING PSYCHOGENIC SEIZURES

To determine the use of procedures or techniques designed specifically to precipitate events in patients suspected of having psychogenic sei zures, a survey regarding induction procedures was conducted by solici ting information from physicians and nurses at 60 epilepsy programs wh ich are members of The National Association of Epilepsy Centers. A sur vey instrument was used to (a) identify prevalence, methods, and proto cols of induction use (i.e., to identify the ''standard of care'' rega rding this procedure); (b) identify reasons for use and nonuse of indu ction procedures; and (c) determine whether physicians' responses and nurses' responses differed regarding their views and perspectives abou t induction procedures. Responses were received from 51 of 60 centers, for a response rate of 85%; 27.4% of centers do not use induction pro cedures of any kind. Of the centers using induction procedures, 56.8% use intravenous saline and 29.7% use a placebo patch. Most centers use two or more techniques, commonly combining intravenous saline or plac ebo patch with hyperventilation, photic stimulation, or verbal suggest ion. Additional findings from the study regarding mental health consul tation, concerns expressed by health professionals, and ethical issues are reported.