Table 3: Historical and Clinical Details Suggesting a Diagnosis of Psychogenic Nonepileptic Seizures


Historical features
Associated (often multiple) psychiatric disorders

Flurries of seizures or recurrent “pseudostatus” epilepticus leading to multiple emergency visits or hospitalizations

High seizure frequency

History of sexual and physical abuse

Lack of concern (“la belle indifference”) or excessive/exaggerated emotional response

Multiple unexplained physical symptoms

No history of injury from seizures

No response or paradoxical increase in seizures with AEDs

Personal, family or profession experience with epilepsy

Seizures occur only in presence of others or only alone