Pseudoseizures with urinary incontinence in a child with Neuromyelitis optica: a rare association

Authors

  • Chamelee A. Department of Psychiatry, Saveetha Medical College, Chennai, Tamilnadu, India
  • Raman K. Department of Psychiatry, Saveetha Medical College, Chennai, Tamilnadu, India
  • Shanthi Nambi Department of Psychiatry, Saveetha Medical College, Chennai, Tamilnadu, India
  • G. S. Chandraleka Department of Psychiatry, Saveetha Medical College, Chennai, Tamilnadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20193945

Keywords:

Epilepsy, Neuromyelitisoptica, Pseudoseizures or Psychogenic Non-Epileptic Seizures, Pseudoseizures, Urinary incontinence

Abstract

Background: Paroxysmal non epileptic events or pseudoseizures are common seizure mimics in children. But occasionally PNES events can present or coexist along with organic neurological disorders complicating the clinical scenario posing great challenges for diagnostic and therapeutic implications. Unusual symptomatology in PNES like frothing, tongue bite or urinary incontinence can be seen in PNES. Here, we present a rare case of pseudoseizures with urinary incontinence in a child with Neuromyelitis optica which posed a challenge for diagnosis and proper management with a favourable clinical outcome. A 14 years old girl who was known diagnosed case of Neuromyelitis optica on treatment with oral steroids presented with a history of repeated attacks of involuntary movements affecting all four limbs preceded by a feeling of fear and pain and these events were associated with urinary incontinence. Electroencephalogram and magnetic resonance imaging were performed on the patient. Ictal video EEG confirmed the diagnosis of pseudoseizures. Neuropsychological evaluation was performed which revealed multiple psychological stressors. Repeated counseling sessions and psychotherapy provided significant improvement in the form of remission of pseudoseizures.

References

Reilly C, Menlove L, Fenton V, Das KB. Psychogenic nonepileptic seizures in children: a review. Epilepsia. 2013 Oct;54(10):1715-24.

Reuber M, Jamnadas‐Khoda J, Broadhurst M, Grunewald R, Howell S, Koepp M, et al. Psychogenic nonepileptic seizure manifestations reported by patients and witnesses. Epilepsia. 2011 Nov;52(11):2028-35.

Benbadis SR, Hauser WA. An estimate of the prevalence of psychogenic non-epileptic seizures. Seizure-European J Epilep. 2000 Jun 1;9(4):280-1.

Patidar Y, Gupta M, Khwaja GA, Chowdhury D, Batra A, Dasgupta A. Clinical profile of psychogenic non-epileptic seizures in adults: A study of 63 cases. Ann Indian Acad Neurol 2013;16(2):157-62.

Nakano H, Tanaka M, Kinoshita M, Tahara M, Matsui M, Tanaka K, et al: Epileptic seizures in Japanese patients with multiple sclerosis and neuromyelitisoptica. Epilepsy Res. 2013 Mar;104(1-2):175-80.

Mellers JD. The approach to patients with non-epileptic seizures. Postgraduate Med J. 2005 Aug 1;81(958):498-504.

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Published

2019-08-27

How to Cite

A., C., K., R., Nambi, S., & Chandraleka, G. S. (2019). Pseudoseizures with urinary incontinence in a child with Neuromyelitis optica: a rare association. International Journal of Research in Medical Sciences, 7(9), 3553–3555. https://doi.org/10.18203/2320-6012.ijrms20193945

Issue

Section

Case Reports