—Dr Rosenberg makes an interesting observation regarding the utility of geotropic eye movements as a manifestation of psychogenic (pseudo-)seizures. As was indicated in Table 3 ("Physical Manifestations of Seizures") of our "Ictal Characteristics of Pseudoseizures" study,1 spontaneous geotropic eye movements were not observed. In 22 of 25 patients in the psychogenic seizure group, no clear eye manifestations were observed. However, the specific test suggested by Dr Rosenberg was not performed on these patients. It is indeed possible that performing such a directed examination of eye movements as part of the interaction during an apparently psychogenic seizure may provide valuable information. The authors would like to thank Dr Rosenberg2 for his suggestion, and we will attempt to add his testing to our interaction protocol for patients with suspected psychogenic seizures.
Gates JR, Whalen S, Ramani V. Geotropic Eye Movements and Pseudoseizures-Reply. Arch Neurol. 1986;43(6):544. doi:10.1001/archneur.1986.00520060008006