www.baltimoresun.com/health/blog/bal-poh-seizures-not-all-epilepsy,0,6456354.story

baltimoresun.com

Not all seizures mean epilepsy

By Meredith Cohn

7:00 AM EDT, April 13, 2012

Advertisement

Stress is behind some seizures rather than the neurological disorder epilepsy, researchers at Johns Hopkins have determined.

A team of doctors and psychologists evaluated patients admitted to Hopkins’ inpatient epilepsy monitoring unit for treatment of intractable seizures. They believe a third have symptoms only mimicking epilepsy and have been misdiagnosed.

These are war veterans, mothers in child-custody battles and over-extended professionals. They seem to have uncontrolled movements, far-off stares or convulsions, but the symptoms are not the result of abnormal electrical discharges in the brain characteristic of epilepsy.

The findings, published online in the journal Seizure, are based on the researchers’ clinical experience and observations. Their biggest clue is anti-seizure medications don’t stop the symptoms.

They say these pseudo seizures a “conversion” disorder where the patients unconsciously convert emotional dysfunction into physical symptoms. The patients can even become paralyzed or blind.

In the past, doctors haven’t advertised the condition for fear those at risk are highly suggestible. But a group of New York high schoolers recently got attention when they developed ticks and movements. Researchers say they are likely psychiatric rather than neurological in origin.

The sufferers tend to lack coping mechanism to deal with stress and are more distressed by events.

“These patients behave as if they have an organic brain disease, but they don't,” Jason Brandt, the study's senior investigator and a professor of psychiatry and behavioral sciences and neurology at the Hopkins School of Medicine, said in a statement.

“And it turns out that their life stresses weren't all that high, but they're very sensitive to stress and they don't deal with it well.”

Researchers don’t know how many people experience pseudo seizures or why some overwhelmed people suffer from them and others don’t. They also don’t know the number of sufferers appears to be increasing.

As treatment, cognitive behavior therapy is used to help sufferers develop effective coping skills.