I read with interest the recent commentary by O’Hanlon et al.1 The authors make a passionate argument for abandoning the term pseudoseizure and replacing it with psychogenic nonepileptic seizure. While I agree with the authors that the term pseudoseizure is misleading and implies that the patient is intentionally feigning an illness (in this case seizures), the authors' proposed terminology of psychogenic nonepileptic seizure is not free of controversy itself. It assumes that the patient's typical event is psychogenic in origin. The word seizure at the end of the term risks sending a mixed message to the patient and family (“You do not have a true seizure, but rather some other kind of seizure”), adversely reinforcing the disease process. If after investigations the patient's typical events are determined to be nonepileptic, the term nonepileptic event should be used. Events that are clearly physiological, such as tremors, myoclonus, dystonia, or other movement disorders, should be referred to as a physiological nonepileptic event until better characterized by additional testing. Psychogenic nonepileptic events should be the preferred term if typical events are clearly psychogenic in origin. Whether the underlying etiology is a conversion, somatoform, or factitious disorder can then be determined, further refining the diagnosis and guiding treatment forward.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Neurology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
The Rational Clinical Examination
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.