Epilepsy and Conversion Relationship: The Importance of EEG

Epilepsy is a neurological disorder, which is characterized by recurrent episodes upon the occurrence of excessive electrical discharge as the brain shows abnormal electrical activities following the deterioration of its normal activity. This is a disorder, which requires a serious expert follow-up and treatment and which requires one to be patient and use objective methods while diagnosing it. Epileptic episodes are significant in terms of differential diagnosis based on age and the way these episodes occur.

Non-epileptic episodes are also called pseudo-episodes, conversion, hysteric and psychogenic episodes. These episodes are very similar to epileptic episodes, yet they can be defined as attacks, in which epileptic change and epileptiform discharge are observed during Electroencephalography (EEG) processes.

Conversion episode cases are generally observed in women with a 75% frequency, and are dense in the age range of 30-40. According to the opinions of the researchers, women express desperation, fear and anger through conversion episodes. According to a research carried out by Bowman et al. (1996) over an adult sample of 45 people, while it draws the attention that %69 of the patients had childhood period sexual traumas, this rate is %24 in some researches. Only conversion episodes were detected in almost 20% of the patients, who resisted drugs, in the consultations at epilepsy centers. Nevertheless, at some centers, it was also observed that 10% – 58% of the patients going through conversion episodes also had epileptic episodes accompanying the conversion.

During the phase of diagnosing patients, who come to the clinics under the Suspicion of Epilepsy, data given by patient relatives, such as the duration, frequency, general description and the way of ending of the episodes, are generally used. Nevertheless, it is highly important to use EEG during the diagnosis phase, as the methods of observing epileptic and non-epileptic episodes are very similar.

In EEG, the waves observed during epileptic episodes are called “epileptiform electrical discharges”. These discharges observed in the waves are sharp, abnormal activities with high voltages and a thorn-like appearance. These findings provide considerable answers on whether a patient having those complaints suffers from epileptic or non-epileptic episodes.

As a result, conversion episodes must also be kept in mind during the differential diagnosis of all episodes, and episodes showing resistance to drugs must be particularly analyzed through the follow-up made by an experienced neurologist.

Prof. Dr. Kemal Arıkan