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Provocative Testing Should Not Be Used for Nonepileptic Seizures
John R. Gates, MD
From the Minnesota Epilepsy Group PA, St Paul; and the Department of Neurology, University of Minnesota, Minneapolis.
Arch Neurol. 2001;58:2065-2066.
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IN AN era of increasing pressures for cost-effective diagnoses, there are considerable incentives to integrate procedures, which may trigger a paroxysmal event when no spontaneous episodes are occurring. Provocative tests (PT) for the diagnosis of nonepileptic seizures (NES) have included several techniques: intravenous saline, a tuning fork applied to the forehead, an alcohol pad placed on the skin or the carotid artery, psychiatric interview, hypnosis, and the use of anhydrous ammonia.1-14 Hyperventilation, photic stimulation, and obstruction of the airway have also been used to provoke NES in patients. The most commonly employed technique is the use of intravenous saline in combination with suggestion.
Schachter et al12 surveyed members of the American Epilepsy Society (West Hartford, Conn) about their use of PT. Overall, 40% of the 426 respondents indicated that they use PT, and 92% indicated continuous use of electroencephalography during the procedures. The PT most commonly . . . [Full Text of this Article]
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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Nonepileptic Seizures: An Honest Approach to Provocative Testing Is Feasible
McGonigal et al.
Arch Neurol 2002;59:1491-1491.
FULL TEXT
Outpatient video EEG recording in the diagnosis of non-epileptic seizures: a randomised controlled trial of simple suggestion techniques
McGonigal et al.
J. Neurol. Neurosurg. Psychiatry 2002;72:549-551.
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