Psychogenic chemical sensitivity: Psychogenic pseudoseizures elicited by provocation challenges with fragrances

A middle-aged woman with a 10-year history of disability attributed to chem ical sensitivities complained that exposure to specific fragrances immediat ely elicited seizures. Video-EEG monitoring was performed in a hospital neu rodiagnostic laboratory during provocative challenge studies employing frag rances identified by the patient as reliably inducing symptoms. The baselin e clinical EEG was normal. Immediately after each provocation with air deod orant and perfume, she consistently showed both generalized tonic/clonic an d multifocal myoclonic jerking, at times was nonresponsive, spoke with slur red speech, and complained of right-sided paralysis and lethargy. None of t hese events were associated with any EEG abnormalities. Psychological asses sment (MMPI-2, MCMI-II) revealed personality traits that predisposed her to somatization and beliefs about environmental sensitivities. The convulsion s were a manifestation of psychogenic pseudoseizures that had been iatrogen ically reinforced. (C) 1999 Elsevier Science Inc.