MedUNAB (Dec 2006)
Non epileptic psychogenic crisis in infantile psychiatry
Abstract
The non epileptic psychogenic crisis are paroxistic episodes of alteration in the movements, sensations or experience that can imitate a convulsive crisis, strongly associated with emotional suffering and not associated to abnormal electrical brain discharges. This entity can happen at any age and prevails in the female gender. It is considered to be an involuntary expression associated with emotional difficulties. It is a vague diagnosis, but of great utility. It shows multiple forms such as rotary movements of the head or pelvis, kicking, changeable crisis and they are easily suggestionable. In children, the studies show great comorbidity with entities such as depression, anxiety, epilepsy, school rejection, panic disorder, and others. The diagnosis is clinical, where the video telemetry is the most important examination. A local experience is described with 12 patients, predominantly women (84%) between 7 and 17 years, which consulted principally for convulsions (83%). Anxiety was the principal symptom found (58%), continued by depression in (41%), and familiar malfunction (25%). 66% of patients had focal epilepsy and 50% of the cases presented psychogenic epileptic state. The most used medications in neuropediatry were carbamazepine, valproic acid and, for psychiatry, fluoxetine. The pseudocrises turn into events of great importance because they evidence a series of emotional alterations that explain similar symptoms of a convulsion.
