Neuropsychological Assessment in the Diagnosis of Nonepileptic Seizures

Abstract

The diagnosis of epilepsy is often a rather straightforward matter. The clinical episodes are classic, the EEG is confirmatory, and the response to medications is positive. At other times the picture is murky. The spells are of an uncharacteristic type, EEG findings of uncertain clinical significance are obtained, and the neurologist subsequently struggles with issues of differential diagnosis, for example, are the spells caused by cardiac disease, cerebrovascular disease, migraine, or some other neurological or systemic process? Often, but not always, the etiology underlying these nonepileptic phenomena is identified and treated, and the patient subsequently improves. In both of these scenarios, the neurologist does not question the organic nature of the attacks, and consultation from the psychology service is neither mandatory nor asked for.