Psychological factors in the genesis and management of nonepileptic seizures: Clinical observations

George P. Prigatano, Cynthia M. Stonnington, Robert S. Fisher

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Nonepileptic seizures (NES) are frequently thought to have a "psychogenic" basis. Two 6-month group psychotherapy programs were provided for patients diagnosed as having NES [eight patients were treated during the first program, seven during the second (N = 15)] to explore the potential role of psychological factors in the genesis of NES and to determine if psychotherapeutic interventions reduced the frequency of NES. Of the 15 patients, 9 (60%) completed at least 58% of the treatment sessions. Of those 9 patients, 6 (66%) reported a decline in "seizure frequency." One reported an increase (11%). Self-reported frequency highly correlated with paranoid ideation. Dissociative phenomena were common as was a history of sexual abuse. Each patient reported being in an adult situation that they found unacceptable or intolerable. None perceived a solution to their situation. Reports by health care providers that their seizures were not "real" (i.e., true epilepsy) restimulated feelings associated with their not being believed when they reported being sexually abused as children. The psychological genesis of NES in this sample of patients appears rooted in the recurrent experience of being in abusive or exploited relationships for which they perceived no solution.

Original languageEnglish (US)
Pages (from-to)343-349
Number of pages7
JournalEpilepsy and Behavior
Issue number4
StatePublished - Aug 2002


  • Anger
  • Depression
  • Dissociative reactions
  • Group psychotherapy
  • Nonepileptic seizures
  • Paranoia
  • Pseudoseizures
  • Sexual abuse
  • Social isolation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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