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Clinical profile of patients with epileptic and nonepileptic seizures

From the Department of Neurology, New York University School of Medicine and Hospital for Joint Diseases, NY.
Received September 6, 1995. Accepted in final form November 13, 1995.
Address correspondence and reprint requests to Dr. Orrin Devinsky, Department of Neurology, Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.

Epileptic seizures (ES) and nonepileptic seizures (NES) often coexist in patients with treatment-refractory seizures. There are few data on ictal features of these different seizure types in the same patient. We identified 20 patients with ES from a group of 99 NES patients (ES/NES) and compared this group with patients with only ES or NES. All 20 ES/NES patients developed NES after ES. Clinical features of NES clearly differed from ES in 18 of 20 cases. In patients with ES/NES their ES were similar to seizures in patients with only ES, and their NES were similar to spells in patients with only NES. ES/NES patients were similar to ES patients in electrodiagnostic and neuroimaging studies, and similar to NES patients in psychiatric interviews and inventories. The clinical manifestations of ES and NES in the same patient are usually different. Both types of events may be stereotypic and can be distinguished and characterized during video-EEG recording. Determining what events are more prevalent or disturbing is critical. Psychiatric and antiepileptic drug treatment may be provided accordingly.

NEUROLOGY 1996;46: 1530-1533

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