Psychological Factors Involved in Bizarre Seizures

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Abstract
Attention is directed to that borderland which exists between the clinical neurologist who is confronted with a bizarre seizure problem and the clinical psychiatrist who faces an emotionally disturbed patient with probable epilepsy. Four cases from a series of 20 are reported. Common denominators existed such as marked psychological difficulty prior to the onset of symptoms and problems in group adjustment, especially in developing self-discipline in social behavior. Seizures usually occurred in clusters serving temporarily to control the environment and resolve conflicts. Only by a team approach, via psychiatrist and neurolgist, can effective treatment be accomplished. Since the patient may make use of physical needs as a defense against psychiatric exploration, a clear division of roles is essential. The term hysteroid epilepsy has been opposed because it offers a confused picture of the patient''s difficulties and implies that seizures and their psychological concomitants occur only in hysterical personality structures. The concept is proposed that emotional conflict in susceptible individuals results in a lowering of the seizure threshold beyond a certain critical level resulting in seizures.

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