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Dissociation

  • Matthias SchmutzEmail author
Part of the Neuropsychiatric Symptoms of Neurological Disease book series (NSND)

Abstract

Dissociative seizures represent a psychiatric symptom with a long tradition going back to the ancient Egyptian and Greek medicine. Due to their semiological similarity to epileptic seizures, establishing the proper diagnosis requires specialized neurological expertise. This chapter gives a short review of the relevant psychological theories about psychosomatic conversion and dissociation, which constitute the etiological and pathogenetic background of dissociative seizures. Furthermore, the major issues of the neurological differential diagnosis, the psychiatric and psychodynamic inclusion diagnosis, and the challenging clinical management of patients with dissociative seizures are comprehensively summarized and discussed. Finally, the current research data on treatment, outcome, and prognosis are critically reviewed. From a psychiatric point of view, dissociative seizures do not represent a disorder in the nosological sense, but merely an accompanying symptom of an underlying psychiatric disorder. Based on this perception, guidelines for clinical management and treatment can be improved. In addition, this shift in focus could foster future research by clarifying some methodological problems limiting the research findings so far.

Keywords

Dissociative Seizures Conversion Seizures Psychogenic Non-Epileptic Seizures Hysteric Seizures Hysteria Somatoform Disorder Somatization Dissociation Trauma-Related Stress Disorder Psychotherapy Psychiatric Nosology Differential Diagnosis 

Notes

Acknowledgment

I am grateful to Martin Kurthen for his hints and critical comments.

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Psychiatry/PsychotherapySwiss Epilepsy CenterZurichSwitzerland

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