PSYCHOGENIC SEIZURES IN OLD-AGE - A CASE-REPORT

Psychogenic seizures are unusual after age 60 years. A 73-year-old wom an had onset of psychogenic seizures at age 69 years. Five to six atta cks occurred each month, usually at night, characterized by an initial subjective sensation and headache followed by generalized stiffening and shaking. Continuous EEG-closed circuit television (EEG-CCTV) monit oring clearly showed these episodes to be nonepileptic. Discontinuatio n of antiepileptic drugs (AEDs) did not increase the frequency or seve rity of attacks. Epileptiform discharges were not recorded during the awake, drowsy, or sleeping states. Psychiatric evaluation identified s ignificant turmoil in the patient's life and a history of childhood se xual and physical abuse. Psychogenic seizures may begin in old age and should be considered in the differential diagnosis of intractable sei zures in the elderly. Predominantly nocturnal occurrence should not ex clude the diagnosis.