Epilepsy or Psychological Seizures?
Eye Movements May Help Doctors Tell the Difference
WebMD News Archive
June 12, 2006 -- A surprisingly large percentage of epilepsy patients who do
not respond to drug treatment don't really have epilepsy at all. It often takes
a decade or longer for these patients to get a correct diagnosis -- but new
research finds there are simple clues that can make a correct diagnosis
A patient's eye movements during a seizure can help distinguish seizurescaused by epilepsy from those
psychological in nature.
That is the finding from one of three new studies examining the diagnosis of
non-epileptic seizures published in the June issue of the journal
Videos of Seizures
Researchers from the Barrow Neurological Institute in Phoenix, Ariz.
reviewed videos of 221 people having seizures. They found that 50 of the 52
people having non-epileptic seizures closed their eyes during the event, while
152 of 156 having epileptic seizures kept their eyes open or blinked until the
seizure was over.
Researcher and neurologist Steve S. Chung, MD, says that observation could
potentially shorten the time to an accurate diagnosis for many patients.
"We need to confirm these results, but these findings could help guide
us toward the appropriate diagnosis early on," he says. "In our
experience, family members can accurately describe whether a patient's eyes
were open or closed during a seizure."
Getting a Correct Diagnosis
Roughly one in three patients with a diagnosis of epilepsy is not helped by anti-seizure drugs. It
is believed that as many as a third of these patients don't have epilepsy at
Instead of being caused by abnormal electrical activity in the brain, as is
the case with epilepsy, the non-epileptic seizures are psychological in origin.
University of South Florida neurologist Selim R. Benbadis, MD, tells WebMD
that it takes an average of seven to nine years for patients with psychological
non-epileptic seizures to get a correct diagnosis.
Recording Electrical Signals
This can usually be done with a video-electroencephalogram (EEG), but that
test is not performed as often as it should be, Benbadis says. An EEG records
electrical signals in the brain through sensors placed on the scalp. In the
video-electroencephalogram, patients are videotaped while their EEG is
recorded, usually over the course of several days.
"Neurologists don't tend to suspect non-epileptic seizures early on,
even when the patient is not responding to drugs," Benbadis says. "They
often try different drugs for years without success."
Understanding the difference between epileptic and non-epileptic seizures
could help raise suspicion earlier and help a large number of patients avoid
years of unnecessary drug treatment, Benbadis says.