CLOSED EYES DURING A SEIZURE INDICATE PSYCHOGENIC ETIOLOGY - A STUDY WITH SUGGESTIVE SEIZURE PROVOCATION

Psychogenic seizures are often difficult to distinguish from epileptic seizures. A saline infusion test with suggestion is a useful tool for diagnosis because psychogenic seizures can be elicited in about three -fourths of patients. We analyzed 100 psychogenic seizures provoked by suggestion in patients with and without a history of epileptic seizur es. Most patients showed bilateral movements of the limbs, including h ead movements and pelvic thrust, mimicking generalized seizures. Ninet y percent of patients had closed eyes, an uncommon feature during an e pileptic generalized seizure; 10% of patients had open eyes. These pat ients frequently had a history of epileptic seizures. Suggestive provo cation proved a safe and reliable diagnostic tool.