I've been friends with a person for 10 years. She has this seizure disorder that no one can figure out. Even when we were 13 years old I could sense that something just wasn't right. She has been to four or five different states to receive treatment. She gets so mad when the doctors tell her that they can't find anything wrong with her. Her symptoms have changed so much since she first started having seizures. She has told me that it was neurologic related, cardiac related, musculoskeletal related, and GI related. She had symptoms such as her legs hurting, headache, back pain, stomach ache, memory loss, numbness, chest pain, and many others. She's had tons of proceedures including a heart cath and multiple MRI's and EEG's and still no one has been able to diagnose her. She's even told me that doctors have suggested psychiatric treatment and she gets very very mad and offended. I NEVER would accuse anyone of faking something so serious but just some of the things she says makes me sort of suspicious and uncomfortable. She came to visit me and a bunch of us went out, including her ex-boyfriend that she is still crazy about. She went on and on all evening long about how she hadn't had a seizure in so long. Then, she started to seize in a bar. She was taken to the hospital and when I went in to see her the first thing she said was "Well, I guess (ex-boyfriend) knows how sick I really am now. Maybe he'll treat me a little better." I'd been very supportive of her until then. Now I just try to change the subject when she wants to talk about her illness (which is just about all of the time) and she gets very aggrivated with me. I don't know what to do. Is there anyway I can know she isn't really having a seizure? I just started researching Munchausen's today and I had never heard of it before. If she is truly faking it, is there anyway I can help her?
Specializes in psych, addictions, hospice, education.
Pseudoseizures are sometimes very misunderstood. Pseudo doesn't mean she's faking it. It just means there's no objective evidence for it. I doubt your friend is consciously doing this. If she is having seizures, there's a reason for it, emotional or physical. In my practice I've seen many who have seizures because they can't talk about their emotional stress and that comes out as a seizure....
I have a very similar question that I would love to have answered. I also have a friend who has been suffering from what she claims to be "non-epileptic" seizures. It will start by her passing out, generally while she is talking to someone. I have witnessed this on several occasions. Just this past week, it happened again. Right before she fainted, she said "wouldn't it be funny if I passed out?". She then proceeded to pass out again and hit her head on a hard floor. She, like always, was back within 5 minutes. However, I noticed even when her eyes were "rolling back" she was smiling at things that I said. Her and I were sitting waiting to get some ice for her head as she had developed a sizable bump and she told me how things tended to be worse when she hadn't had anything to drink or eat, which she hadn't that morning. Suddenly, she passed out once again. This time, she began convulsing. I immediately turned her on her side and tried to get a response. She was gasping and I was able to get her to say she was feeling intense nausea. However, she was then completely unresponsive to touch and light. After around 5 minutes the convulsions stopped and she was unconscious for almost 40 minutes, every 5 or so her eyes would fly open and she would gasp, clenching her fists. It was 40 minutes before those around us finally called, and received, an ambulance. The paramedics asked me some questions and told me that she was not very deep in unconsciousness. They also guaranteed to me that she would wake up in the ambulance. Right before they took her away, I reminded her how she didn't want to be put in an ambulance and she smiled! How does one smile when unconscious? That night she phoned me and told me she couldn't remember anything that happened, but then she told me something that I said to her while waiting for the ice. She had claimed this exact memory loss when we had been waiting for the ice as well. I am very suspicious of these "seizures" but I know I can't say anything to her. I want to be supportive but I'm not sure if this is just a case of munchausen's or the real deal. The fact that she always passes out after mentioning that it would be "funny" if she did causes me great suspicion as well as the fact that there are some inconsistencies in her stories.
Specializes in psych, addictions, hospice, education.
I would like to suggest another possibility in this, and it's my interpretation of some pseudoseizures. Sometimes people can't deal with the stress in their lives and it comes out in physical symptoms. Sometimes people don't get comfort or attention from others unless they are sick. Sometimes it's not allowed to show emotion. Some cultures don't allow emotion-expression if it's negative emotion. The pseudoseizures may be subconsciously triggered as a response to all of this.
Specializes in Management, Emergency, Psych, Med Surg.
From the sound of it you have a person there who is in great need of psychiatric evaluation and ongoing counseling. She may in fact be having pseudoseizures. They are a reaction to psychic trauma and I used to see it a lot with patients who had experienced past sexual abuse. She may very well have Munchausen's. Until she is willing to get help there is nothing you can do. What you don't want to do is become an enabler. It sounds like she has a real talent for sucking people in. Diane
When I started reading your post Bennet91 I began to think that perhaps you were seeing what's called an 'absence' or used to be "petit mal" and then a full blown seizure. Absences are types of seizures where the person just blanks off. They tend not to fall over tho and it looks more like a - well - absence; as if in a deep trance or day dream - like they're not there. It doesn't usually involve eyes rolling into back of head; just a blank stare.
Full blown seizures - nowadays not known as 'grand mal' - but tonic-clonic - are essentially the body going into a full-on electrical short circuit of the brain. They can be partial (usually 'tics' or tremors and effecting only parts of the body; consciousness often remains) or complex - effecting the whole brain and ergo the body. However, they usually begin spontaneously (often an aura is felt by the person) and these are where the eyes may roll up and around.
If someone is having a complex tonic-clonic, they're pretty much unable to take in anything and the brain is technically 'unconscious' throughout - it cannot receive and interpret data as it's undergoing a little self-frazzle time as the neurons fire off electrical random impulses continuously.
The spasms of a seizure are caused by the electrical activity traversing down the body and electrically impulsing the muscles - there is no control over this. If you want to see a scale down version, try attaching a TENS machine to your face and have a little play. [i forget the movie where someone 'did' that - it cracked me up. Was it 'G' with Eddie Murphy?]
Anyhow - back to the lady in question - I'm not convinced she fits this description but there are some things that do fit the bill. eg taking long time to recover; the gasping that may fit the non-epileptic category.
With the gasping - again; electrical activity disruption causes the diaphragm muscle to contract - thus not allowing the full inhalation process to take place and hence the 'gasping'. However, this again is not something you can 'fake' and is very distinct in epileptic seizures compared to non-epileptic seizures.
I've seen a few fakes over the years - and some non-epileptic - but oddly never seen a real one. Actually - I tell a lie! I have seen one when I was teaching a fist aid class - and one of the students started having a tonic clonic for about 15 seconds. Talk about having to put your money where your mouth is!
It's surprising how many medics can't (or won't?) make out a non-epileptic one and still go the full anticonvulsants pathway. I don't usually interfere til after the PR Valium is given tho - as this is probably therapeutic.
There is no physical way in a full tonic-clonic someone can talk, let alone hear and interpret the question. And the recovery after a tonic-clonic is extensive due to the sheer exhaustion of having every muscle in your body contract at once and repeatedly.
However, it may be that your friend is having a psychogenic seizure - an emotional trauma induced seizure. Used to be called pseudo-seizures but now a recognised process of reaction-conversion - converting emotional trauma into physical ones which are more readily acceptable to the gazing public.
Nonepileptic seizures are classified as having a physiologic or a psychogenic basis.
Physiologic nonepileptic seizures are caused by a sudden disruption of brain function, from a metabolic disturbance such as profound hypoglycemia or hyponatremia, or ischemia from cardiac arrhythmia.
Psychogenic nonepileptic seizures result from stressful psychological conflicts or major emotional trauma, often stemming from sexual and/or physical abuse, current or in the past, especially in childhood. Other causes include major life events such as death or divorce.
Generally you can tell the psychogenic seizure by whether the muscles appear tense both extensor and flexor at the same time - eg tricep and bicep. Usually someone having a non-epileptic seizure just generally shakes themselves about and the muscle tone is all wrong.
First Aid Treatment for NES remains same principles of Airway, Breathing, Circulation - but does not always require the emergency services follow up and may respond to emotional support.
However, as I'm not a neurologist, I might not be completely right [disclaimer covered - tick].
Whispera, MSN, RN
3,458 Posts
Pseudoseizures are sometimes very misunderstood. Pseudo doesn't mean she's faking it. It just means there's no objective evidence for it. I doubt your friend is consciously doing this. If she is having seizures, there's a reason for it, emotional or physical. In my practice I've seen many who have seizures because they can't talk about their emotional stress and that comes out as a seizure....