Dissociation in temporal lobe epilepsy and pseudo-epileptic seizure patients

Patients with epileptic seizures (ES) and especially those with temporal lo be epilepsy (TLE) share many symptoms with patients with pseudo-epileptic s eizures (PES), and the differentiation between them is often difficult. The re is growing evidence that a subgroup of PES patients suffer from a dissoc iative disorder. It is recognized that dissociative symptoms pertain to bot h psychological and somatoform components of experience. Questionnaires ass essing dissociation might provide positive criteria for the diagnosis of PE S. In this study, the Dissociation Questionnaire (DIS-Q) and the Somatoform Dissociation Questionnaire (SDQ-20) were administered to patients with ES (TLE, non-TLE) and PES. To control for the influence of general psychoneuro tic complaints, the SCL-90 was administered. Apart from this, answers on a trauma questionnaire were related to the diagnosis. Results showed that PES patients scored significantly higher on the SDQ-20, also after correction with the SCL-90, and no difference was found on the DIS-Q. Also, PES patien ts significantly more often reported sexual traumatic experiences. A logist ic regression revealed that results on the SDQ-20 have no independent value in addition to the contribution of gender, age, age at seizure onset, and the presence of sexual abuse in the prediction of the diagnosis. In conclus ion, somatoform and not psychological dissociative symptoms are characteris tic for PES patients in comparison to ES patients. Other measures are neede d within the framework of the differential diagnosis between PES and ES.