Weeping During Psychogenic Nonepileptic Seizures

Authors

  • Thaddeus S. Walczak,

    Corresponding author
    1. Department of Neurology, Comprehensive Epilepsy Center, College of Physicians & Surgeons, Columbia University, New York, New York, U.S.A.
    Search for more papers by this author
  • Alexei Bogolioubov

    1. Department of Neurology, Comprehensive Epilepsy Center, College of Physicians & Surgeons, Columbia University, New York, New York, U.S.A.
    Search for more papers by this author

Address correspondence and reprint requests to Dr. T. Walczak at Neurological Institute of New York, Box 183,710 W. 168th St., New York, NY 10032, U.S.A.

Summary:

Ictal weeping may help distinguish psychogenic nonepileptic seizures (PNES) from epileptic seizures. However, the prevalence of weeping during PNES or epileptic seizures is unknown. We reviewed videotapes of recorded events in 84 consecutive patients with PNES or epilepsy. Weeping was observed during 14% of PNES in 31% of patients with PNES. Ictal weeping was not observed in any epileptic seizures occurring in 48 patients. The differences were highly significant. One patient with epileptic seizures originating in the right temporal lobe wept soon after the end of a seizure. Depression was not more common in PNES patients with than without ictal weeping. Weeping during an apparent seizure strongly argues that the event is not epileptic.

Ancillary