SELF-INJURY AND INCONTINENCE IN PSYCHOGENIC SEIZURES

Two patients who incurred significant injuries during psychogenic seiz ures prompted us to do a telephone survey of self-injury and incontine nce in 102 consecutive patients diagnosed with psychogenic seizures by EEG-closed-circuit TV (EEG-CCTV) monitoring. Seventy-three patients ( or a close family member or friend) were reached by telephone and resp onded to our survey. During typical attacks of psychogenic seizures, 4 0% reported injuries, 44% reporting tongue biting, and 44% reported ur inary incontinence. Suicide attempts were reported by 32% and were mor e common in those with self-injury and urinary incontinence. We compar ed the results of patients with psychogenic seizures with those of 30 patients with refractory epilepsy documented by ictal recordings, usin g a similar telephone survey. Injuries of all types were more commonly reported by epilepsy patients. Burn injuries were reported only by pa tients with epilepsy. Suicide attempts were more commonly reported by the psychogenic seizure group. Self-injury and incontinence are common ly reported by psychogenic seizure patients. In view of their signific ant association with suicide attempts, they may indicate an underlying depression.