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BMJ Case Reports 2017; doi:10.1136/bcr-2016-218278
  • CASE REPORT

Non-epileptic attack disorder: the importance of diagnosis and treatment

  1. Markus Reuber6
  1. 1Academic Unit of Primary Medical Care, The University of Sheffield, Sheffield, UK
  2. 2The University of Sheffield, ScHaRR, Sheffield, UK
  3. 3Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  4. 4Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  5. 5Section of Public Health, ScHARR, The University of Sheffield, UK
  6. 6Academic Neurology Unit, University of Sheffield, UK
  1. Correspondence to Dr Jon Mark Dickson, j.m.dickson{at}sheffield.ac.uk
  • Accepted 4 February 2017
  • Published 1 March 2017

Summary

A 50-year-old woman was taken to hospital by emergency ambulance during her first seizure. She was admitted to hospital, treated with intravenous diazepam, diagnosed with epilepsy and started on antiepileptic drug (AED) therapy. This was ineffective so she was referred to a tertiary centre where she underwent video EEG and was diagnosed with non-epileptic attack disorder. Her experience of the diagnosis was positive; it allowed her to understand what was happening to her and to understand the link between her seizures, adverse childhood experiences and the death of her mother. She stopped taking AEDs and she was referred to a psychologist which led to a significant improvement in her functioning and quality of life. We present this case as a good example of the benefits of accurate diagnosis, clear explanation and access to specialist care.

Footnotes

  • Contributors JMD suggested writing a case report of a patient with NEAD. JMD and MP identified the patient. MP initially approached the patient and asked for permission to use the narrative accounts from another project as the starting point of this case study. JMD reviewed the medical records of the patient, took the lead with writing the case report and liaised with the other authors. The case report was discussed throughout its preparation with all the authors who made important contributions to the manuscript (JMD, MP, RAG, SH, PB and MR). The patient was under the care of MR throughout most of the time period described. The medical, social and family history reported in this case are based on the patient's account. The medical history was verified and augmented using the medical records. Verification was not feasible for much of the social and family history so it is reported here as described by the patient.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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