Outcome of pseudoseizures in children and adolescents: a 6-year symptom survival analysis

Outcome was studied of all children and adolescents with pseudoseizures wit hout epilepsy, who were referred and treated as in-patients and/or day pati ents in the tertiary psychiatric ward at Birmingham Children's Hospital, UK between 1988 and 1994. Information was derived from case-note data. Freedo m from seizures for six months was defined as 'cure', as no recurrences aft er this period were noted. Kaplan-Meier survival analysis was used. Sevente en patients were identified: 15 females and two males; mean age at presenta tion to the tertiary psychiatric service was 12 years 9 months (SD 26 month s; range 8 years 3 months to 15 years 9 months). Fourteen participants reco vered and resumed regular school attendance. Three were lost to follow-up d ue to being referred on to other agencies before recovery because they beca me too old for the service. Recovery followed an exponential distribution, with a mean symptom survival time following treatment of 1.5 years. These r esults are consistent with a treatment effect. Younger age at presentation, female sex, having more types of seizures, and not receiving both in-patie nt and outpatient treatment were associated with better outcome. The deteri orating prognosis with age at treatment suggests prompt identification may be important in ensuring a good outcome.