A female presented with history of episodes of altered sensorium, involuntary movements, memory deficits and headache since the last 6 months. 4 episodes occurred during the day and 2 during sleep. She has been married since 1 year. Most likely diagnosis is:
A i.e. Epilepsy - Somatoform disorders include - Somatization disorders, hypochondriasis, factitious illness (Munchausen's Syndrome) & Mallingering. - Occurence of seizure during night, amnesia (memory deficit) and altered sensorium rules out psychiatric cause (pseudoseizure). Feature Epileptic seizure Pseudoseizure - Nocturnal seizure - Self injury Common Rare - Incontinence (during seizure) - Stereotyped aura - Cynotic skin changes - Postictal confusion Common None - Amnesia for time during seizure & a period of resolving delirium after seizure - Body movements Tonic or clonic Non stereotyped & asynchronous - Suggestions Do not affect Affected by it. EEG: - Spike & wave form Present Absent - Post-ictal slowing - Interictal abnormality Variable Variable
Epilepsy
Somatization disorder
Somatoform disorder
Hypochondriasis