Abstracts

Objective
At the end of this activity, participants should understand that the predictive strength of the Personality Assessment Inventory test (PAI) is greater than the ability of the examiner to elicit a seizure through use of the Alcohol Induction Patch protocol.Rationale
25% of patients referred to Epilepsy Clinics with [dsquote]blackouts[dsquote] have Conversion Disorder or some type of psychogenic event. Power of suggestion through use of the alcohol induction patch provides a way of determining whether the patient is experiencing non-epileptic seizures. The alcohol patch will normally produce only non-epileptic seizures. This procedure, however, sometimes fails to induce a non-epileptic seizure, even though the physician suspects that this is the case.
METHODS: The Personality Assessment Inventory was randomly administered to first time patients, at Epilepsy Institute of North Carolina, beginning in October of 2001. A physician performed the alcohol induction patch protocol during Video EEG to induce seizures in patients whose psychosocial histories suggested Conversion Disorder symptomatology. PAI and inductions were performed in separate departments and information was not shared.
RESULTS: As of May 1, 2002 the PAI had confirmed 60 Conversion Disorders. Alcohol patch inductions were subsequently administered to these patients. The [dsquote]patch[dsquote] provoked seizures in 42 (70%) of these patients. Of the remaining 18 (30%) patients, normal electroencephalograms, background psychosocial histories, and medical histories indicated that 11(61%) were experiencing non-epileptic seizures.
CONCLUSIONS: The Personality Assessment Inventory Conversion Disorder subscale is a powerful tool to aid the physician to distinguish non-epileptic seizures in the absence of positive alcohol patch seizure induction on CCTV-EEG.