DEVELOPMENTAL BACKGROUND AND OUTCOME IN PATIENTS WITH NONEPILEPTIC VERSUS EPILEPTIC SEIZURES - A CONTROLLED-STUDY

Purpose: This study was designed to evaluate the relevance of developm ent emotional stress factors, which are considered to influence emotio nal functioning, as contributing factors in the development psychogeni c symptoms. Methods: Ten patients with nonepileptic seizures (non-ESs) (frequently referred to as psychogenic seizures), in whom diagnosis h ad been confirmed by a placebo-infusion test (PT), and 10 control pati ents with complex partial seizures (ESs) were evaluated with regard to development background by using structured in-depth interviews perfor med by a single interviewer blinded to the diagnosis. In addition, out come assessment in the non-ES group after PT was done. Results: There were no significant differences between groups in developmental psycho social stress or in any single development stress factor. Six months a fter PT, the outcome was favorable in patients with non-ES: six were s eizure free, and two had a considerable reduction in frequency of seiz ures. Conclusions: Our research indicates the following: (a) a high in cidence of development stress factors and functional disturbances may be found in patients with non-ESs and ESs; (b) assessment of developme nt emotional stress and functional disturbances as a basis for validat ing the diagnosis of non-ES should be treated with caution; (c) use of PT followed by supportive information about the nonepileptic origin o f the attacks may have a positive therapeutic effect or help to introd uce psychotherapeutic treatment.