There was a patient/IM that had a possible seizure and the staff that responded were claiming that it was fake because she was alert and oriented.

How do you handle this situation, and how do you know the difference between real vs fake seizures?

I know there are different kinds of seizures. I am new to the jail population of patients and am trying to be safe with the real seizures vs the manipulators.

I am an RN who lost her job and had to get disability when I started having "seizures" at 37. After finding me unconscious while lying in the hallway for the second time in my hospital work setting, I am not allowed to work, drive, bathe alone, swim alone, or ride a bike, according to multiple neurologists. I don't have epilepsy, I apparently have psychogenic non-epileptic seizures. What you might think is fake is very real to me, as I have no control over when it stops or starts and it has taken over my life. I am sure you have people who put these things on to get attention but keep in mind that there actually might be something going on that needs treatment.

claudja, I'm so sorry you're having to go through that. We had an inmate with psychogenic seizures as a result of conversion disorder, and it's difficult for even professionals to understand that what is often referred to as "psuedoseizures" in the medical literature does not mean "fake," but actually means "looks like." I hope you are able to find some sort of help for whatever is causing your psychogenic seizures. There is a huge difference between what you are experiencing and what happens when an inmate fakes a seizure event. I hope my comment did not offend you, as it was not my intent to make light of conditions such as yours.

psysn said:
One trick a coworker shared is rubbing a handful of ice on the person's belly. If they're faking they recover instantly...

And if they are NOT faking it? Are you kidding me? Is that 'trick' in your procedure manual?

Specializes in ED.

I just started working in corrections, but still have my job in the ED. We get a lot of fake seizures in the ED. One thing I usually find, is that the fake seizures are usually preceded by some comment like," if I don't get my pain med, xanax, ect, I will have a seizure." Then lo and behold, when we tell the patient they are not getting the meds, voila! seizure! One night I had I had a young girl tell me if she didn't get her morphine dose, she would seize. I left the room only to be called back by the tech and sure enough, she was flopping on the bed, eyes rolled back. I called another nurse in (he also works in corrections) and very loudly asked him how to perform the "Oklahoma Seizure Test". He responded back, while doing it, that if you rub the instep of the left foot, the right arm will jerk. Interestingly, we got just that response from the young lady. Needless to say, she did not receive any pain meds and was discharged home.

Later that night, I had another young lady do the same thing. She was actually not the patient, but a visitor of the patient. She would have her seizure,and her girlfriend would coddle and coo all over her. She passed the Oklahoma seizure test also. Then whenever I tried to discharge her, she would do the staring blankly at the wall and become unresponsive. I finally got tired of it and used an ammonia capsule. Not only did she become fully responsive, she jumped back about 3 feet (she previously state she couldn't walk), yelled "***", grabbed her coat and ran our the room.

\ said:
the first thing I check is pupillary response.....pupils will generally be dilated and/or sluggish to respond to light. There is almost always nystagmus with the dilated pupils. As soon as they stop jerking I generally start asking questions as if they are awake when I suspect faux seizures.....like do you take seizure meds, what med, when was the last dose, how long have you had seizures, when was your last drug level, was it low, etc. The fakers generally end up answering all the questions accurately, albeit with some drama. After 32 years of ER nursing I can say I've never seen anyone wake up from a seizure and be able to answer those type of questions.

I would like to start this post by saying in no way am I trying to engage in an argument. I just want to to enlighten everyone about my side of the story.I've had epilepsy all my life and I can answer questions after seizures. I use words incorrectly I'm told but I can answer questions accurately. Nurses and doctors claimed I faked seizures as a child. until I was diagnosed after sleep study I actually thought I was crazy. I urge everyone to beware of passing judgements. Seizures are not well understood. They are scary and confusing for the patient.I'm a nurse at a prison and I do see fake seizures. I see real seizures that are deemed "fake" because they are not textbook. News flash not everyone will react the same.

Specializes in Pediatrics, Correctional.

I have been at my facility for 7 1/2 years. I have only had (1) real seizure!!!!!! What does that tell ya? I like the sternum rub to the chest.....that seems to get them. I use to use the ammonia caps, but my supervisor stopped any of us, due to someone might be allergic to ammonia! But I liked the advise of the ink pen lid!!!!!!

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

The jail I worked in had only metal or concrete surfaces, so real seizures always involved blood. If the person didn't bite his tongue, it was pretty hard not to hit his head on something during the fall. So bloodlessness was always a first clue. Being able to converse while "seizing" was pretty telling, too.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Mandiee said:
I would like to start this post by saying in no way am i trying to engage in an argument. i just want to to enlighten everyone about my side of the story.I've had epilepsy all my life and i can answer questions after seizures. I use words incorrectly I'm told but I can answer questions accurately. Nurses and doctors claimed I faked seizures as a child. until I was diagnosed after sleep study I actually thought I was crazy. I urge everyone to beware of passing judgements. Seizures are not well understood. They are scary and confusing for the patient.I'm a nurse at a prison and i do see fake seizures. I see real seizures that are deemed "fake" because they are not textbook. News flash not everyone will react the same.

I have epilepsy too. But after working in corrections & psych I can smell someone faking a seizure. That's also why we check & double check to make sure it's not a real seizure. But it's super easy to tell when someone's faking it. It usually involves talking about "Oh if I don't get this or that" or someone who just wants attention.

Specializes in Pediatrics, Correctional.

It is kinda of funny that we are talking about all of this........low and behold I got one in last nite that is trying his darnest to have a seizure.....keep in mind he does have real seizures according to his medical records from the hospital. But he is an ass and has he never been in our facility before......but he is demanding and wants what he wants when he wants it.....last nite he to the booking officers he was hungry and to get him some G-- D---n food now!!!!!! Then when they did get him a sandwich....he got to cussing some more stating he doesn't eat white bread b/c he is diabetic!!!!! I advised him to take the meat off and eat the meat only! Well that went over like a fart in church! Oh well, don't come to jail then you can eat what you want!!!!!! And of course he was trying his best to have a seizure (fake).....He was hollerying like a hurt animal and moving his arms up and down! Well your breathing, you didn't **** on yourself, your not foaming or drooling, your not thrashing around......I guess that was a new kind of seizure!!!!!

Okay, now a seizure is one of those illnesses you can truly spot when you have a faker. People who are having an active seizure will have these things: Elevated BP, elevated pulse, low 02 sat and not be aware of there surrounding or whats going on. In most cases they will urinate on themselves. Not always but most likely. First thing you need to do is a sternal rub. A person who is truly having a seizure will not react. Also hold their hand over the head and drop it. If they avoid the face when it falls they are aware of what they are doing. IF the vitals are fine then most likely so are they. We had fakers where I used to work all the time. They wanted to get out of the zone so they faked it. When they were told that seizures were very identifiable and given a write up the number of siezures in our facility decreased tremendously. Don't be taken advantage of. Know true signs.

Specializes in ortho, hospice volunteer, psych,.

There is so much ignorance exhibited in the above letter that I scarcely know where to begin. I'm not attacking the writer, only the incorrect facts stated above,

With the types of seizure I have, no one but my husband is aware of when I have a seizure. I have, complex, complex partial and abdominal, I do not loss consciousness or awareness, do NOT pee all over myself or anyone else, or and am able to follow and participate in what's going on around me. I have described what my seizures feel like in other posts. By now, I know wha my seizure triggers are, and know for sure why I have seizures.

They began when I was thirteen months old and which type of seizure I have is dependent on which brain cells happen to be firing at that time.

There will always be people who think they know more that the specialists that I've seen or been taken to be seen as a child, and that is both maddening and frustrating. Before I became disabled, I drove, and participated in any sport I chose (with one exception.)

I realize that there will always be fakers out there. I've been a psych nurse too long, but that does not give everyone else to assume that if someone stating that they have a seizure disorder or that they are having a seizure, that they are faking just because you cannot see symptoms that go with a tonic-clonic seizure.

ImThatGuy said:
I walked back into the jail once to see an inmate that was having a "seizure" after "falling" off his bunk onto the floor. I radioed to the deputy room and had one of the guys come back with his K9. As soon as Stinger entered the pod on lead the "seizing" inmate jumped to his feet and quickly scrambled back to the top bunk. It was a miracle.

Lol, that is too funny!!!!

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