Dissociative seizures-from clinical picture to the treatment

Dissociative seizures are paroxysmal episodes of disturbed behaviour that bear some resemblance to epileptic seizures and are not attributable to any organic disorder, including epilepsy. Dissociative seizures are common, accounting for up to 20% of patients treated for alleged pharmacoresistant epilepsy. In many cases, the correct diagnosis is missed for several years, while patients take antiepileptic drugs without any obvious therapeutic effect. Polypharmacy is common and often the disorder is suspected only after several trials of antiepileptic medication prove ineffective. Dissociative seizures often have a poor prognosis: a majority of patients stay unemployed and their social situations remain poor even if seizures become less frequent or resolve. There have been several case series published and a number of authors have described general principles of treatment. One open promising controlled study of a successful trial of cognitive behavioural therapy has been published.