Psychogenic Nonepileptic Attack Disorders

As many as 20 of patients previously diagnosed with epilepsy (often for years) turn out to have nonepileptic attacks.67 Panic symptoms are usually characterized by a period of hyperventilation, dizziness, palpitations, chest pain, sweating, blurred vision, fatigue, parasthesia, and often overwhelming fear and anxiety. Usually they are easily recognizable, though they sometimes may be difficult to distinguish from temporal lobe seizures. Dissociative Attacks (Pseudoseizures) These are...

Compulsive Valsalva

Children with ID, including those with autistic disorders, may self-induce syncopes resulting in atonic or convulsive anoxic seizures. This may prove a major diagnostic challenge, as epilepsy may also occur in these individuals. Many seizures in Rett syndrome may be the result of self-induced syncopes.31 The mechanisms are very much like the experimental syncopes described by Lempert and colleagues.15 Diagnosis may only be possible with careful viewing of videotape recordings of the event or...

Vasovagal Syncope

Vasovagal syncope is the most familiar and predominant form of neurally mediated syncope. If classic reflex anoxic seizures with reflex asystolic syncope represent a fairly pure vagal attack, vasovagal syncope involves a vasodepressor component with variable vagal accompaniment. Episodes may begin in infancy, sometimes with reflex anoxic seizures, and thereafter are seen at all ages, becoming most dramatic perhaps in old age.14 Tables in medical textbooks or works of epileptology tend to...