Evaluation of dissociative symptoms in patients with pseudoseizures

Background and Objective: Patients with epilepsy often have psychogenic pseudoseizures (PS) in addition to epileptic seizures. PS are very important in clinical practice, as some PS are resistant to treatment and can reduce a patient’s quality of life. However, the pathophysiology of PS is still unclear. PS can occur in non-epileptic patients, and dissociation is presumed to be the underlying mechanism of PS in such patients. Similarly, PS in epileptic patients may be associated with dissociative states. The Dissociative Experience Scale (DES) was developed as a screening tool for dissociative symptoms1, and it is widely used in the field of dissociation research. To clarify the relationship between PS and dissociation, we evaluated general dissociative symptoms in epilepsy patients with PS using a Japanese version of the DES (J-DES). Methods: Subjects consisted of 22 epilepsy patients with PS (male 9, female 13, mean age 34.1 years) and 22 epilepsy patients with no PS (male 10, female 12, mean age 33.8 years). Diagnoses of PS were established using video-EEG monitoring, or on the basis of the semiology of their seizures. There were no significant differences in age, sex, epilepsy type, seizure frequency, years of education, or a number of antiepileptic drugs between the two groups. J-DES was administered in all subjects. J-DES scores were compared between the two groups and analyzed for association with other clinical features