Pasoido-seizures

Here are two funny stories, that though they are second-hand, I thought I'd pass along.

As we in neurology like to say, not all that shakes is a seizure. The statistics are that roughly 50% of patients admitted for seizure monitoring aren't actually having seizures. Their spells are pseudoseizures, which can be conscious or unconscious. With that preface, here are the stories:

1) A colleague of mine was called to the ER last night to evaluate a patient who was having increased frequency of seizures uncontrolled on his medicine. In taking a history, she found that the patient had recently been admitted to the hospital for workup of his seizures. When she asked that patient what they had found regarding his seizures, he said, "oh, they told me that I have a type of seizure called 'pasoido-seizures' or something like that." Obviously someone didn't explain well enough to him what that term means. Either that or his denial is very strong.

2) I heard about another patient a few weeks back who was air-lifted here from another hospital, where she had been sedated/intubated for status epilepticus (prolonged or back-to-back seizures). She was allowed to wake up and had the breathing tube removed. Her first words were, "I told those ER doctors while I was seizing NOT to intubate me because I have pseudoseizures, but they did it anyway." For those who don't know, the ability to talk during a seizure pretty much rules it out as a seizure and definitely rules out status epilepticus. At least the patient had good insight into her problem.