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Pseudoseizure versus Seizures - What's Your Approach?

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Pseudoseizures—the Right Approach By Jeffrey E. Keller MDPublished: 06/09/2014
I recently had to mediate a complaint from a jail deputy about a jail nurse. The jail deputy had called the nurse in to evaluate an inmate who was having seizures. The nurse said that they were pseudoseizures. The deputy was upset because “You’re accusing this inmate of faking. These weren’t faked. I was there and saw them.” He also was upset that “nothing was done” meaning that the patient was not sent to the ER and was not given any anti-seizure medications (the patient had requested Xanax to help control her seizures).

This little vignette has all of the elements of a good seizure/pseudoseizure case: a diagnostic dilemma (are these real seizures or not?), the potential for medical mismanagement if you get the diagnosis wrong, the possibility that the inmate is manipulating the situation, and, above all, a LOT of emotion. Everybody was upset here: The deputy was upset …