Saline infusion: a diagnostic and therapeutic tool in nonepileptic attacks?

Objective. Nonepileptic attacks (NEAs) pose diagnostic and therapeutic uncertainties. Prognosis is poor. Activation procedures like saline infusion have been used for diagnostic purposes. Method. We reviewed 66 consecutive patients with a probable diagnosis of NEA. During the EEG an attempt was made...

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Bibliographic Details
Published in:Epilepsy & behavior 2003-10, Vol.4 (5), p.500-506
Main Authors: Wassmer, E, Wassmer, S.R, Donati, F
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Child
Child, Preschool
Electroencephalography - drug effects
Female
Humans
Infusions, Intravenous
Male
Middle Aged
Nonepileptic attack
Outcome
Prognosis
Provocative test
Saline infusion
Seizures - chemically induced
Seizures - diagnosis
Seizures - drug therapy
Sodium Chloride - therapeutic use
Stimulation, Chemical
Surveys and Questionnaires
Treatment Outcome
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Summary:Objective. Nonepileptic attacks (NEAs) pose diagnostic and therapeutic uncertainties. Prognosis is poor. Activation procedures like saline infusion have been used for diagnostic purposes. Method. We reviewed 66 consecutive patients with a probable diagnosis of NEA. During the EEG an attempt was made to induce an attack with verbal suggestion and saline infusion. Patients were followed up with a postal or telephone questionnaire 4.5 years after the EEG. Results. Saline infusion with verbal suggestion induced in 41 of 66 patients a NEA, i.e., a positive test. Thirty-one patients were followed up. Attacks were reduced in 20 patients, of whom 12 were attack-free. More patients were attack-free at follow-up after a positive (7 of 16) in comparison to a negative (5 of 15) test. Conclusion. A provocative test can be diagnostic in some patients with NEA. An early and firm diagnosis may lead to appropriate treatment and better outcome.
ISSN:1525-5050
1525-5069
DOI:10.1016/S1525-5050(03)00181-1