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November 1995

Psychiatric Classification of Nonconversion Nonepileptic Seizures

Author Affiliations

Neuroendocrine Unit Department of Neurology Beth Israel Hospital 330 Brookline Ave Boston, MA 02215

Arch Neurol. 1995;52(11):1044-1045. doi:10.1001/archneur.1995.00540350030006

Episodic changes in behavior or consciousness that mimic epilepsy yet have no obvious organic cause have been variably referred to as nonepileptic seizures (NES), pseudoseizures, psychogenic seizures, nonconvulsive psychogenic attacks, and hysterical fits.1-6 They encompass a whole range of motor, sensory/experiential, and emotional manifestations. These phenomena are ubiquitously defined by being observable and without electroencephalographic correlates before, during, or after their occurrence. Alper and coworkers1 define two groups of patients with NES: one group satisfies the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition7 (DSM-III-R) criteria for conversion disorder; the other meets the criteria for an Axis 1 DSM-III-R syndrome other than conversion disorder. In this latter group, patients have episodes of anxiety, psychosis, or impaired impulse control. The challenge to clinicians now is to address the issues of pathogenesis and treatment in the context of abnormal biological functioning of the brain.

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