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CONy 2022 | Standardizing SSM in the diagnosis of psychogenic seizures

Various methods of suggestive seizure manipulation (SSM) including activation and provocation techniques are employed by neurologists to diagnose psychogenic nonepileptic seizures (PNES). William Curt LaFrance Jr, MD, MPH, FAAN, FANPA, DFAPA, Brown University, Providence, RI, discusses standardized approaches in SSM. A survey amongst clinicians revealed a variety of procedures used, with some using a mix of activation and provocation methods. A number of neurologists also deliberately misinformed patients when administering SSM, which raises ethical concerns. This interview was conducted during the 2022 World Congress on Controversies in Neurology (CONy) meeting.

Disclosures

Dr. LaFrance has served on the editorial boards of Epilepsia, Epilepsy & Behavior; Journal of Neurology, Neurosurgery and Psychiatry, and Journal of Neuropsychiatry and Clinical Neurosciences; receives editor’s royalties from the publication of Gates and Rowan’s Nonepileptic Seizures, 3rd ed. (Cambridge University Press, 2010) and 4th ed. (2018); author’s royalties for Taking Control of Your Seizures: Workbook and Therapist Guide (Oxford University Press, 2015); has received research support from the Department of Defense (DoD W81XWH-17-0169), NIH (NINDS 5K23NS45902 [PI]), Providence VAMC, Center for Neurorestoration and Neurorehabilitation, Rhode Island Hospital, the American Epilepsy Society (AES), the Epilepsy Foundation (EF), Brown University and the Siravo Foundation; serves on the Epilepsy Foundation New England Professional Advisory Board, the Board of the Functional Neurological Disorder Society, and on the Council of the American Neuropsychiatric Association; has received honoraria for the American Academy of Neurology Annual Meeting Annual Course; has served as a clinic development consultant at University of Colorado Denver, Cleveland Clinic, Spectrum Health, Emory University, and Oregon Health Sciences University; and has provided medico-legal expert testimony.