CONy 2022 | Is inducing psychogenic seizures to diagnose PNES unethical?

Barbara Dworetzky, MD, Brigham and Women’s Hospital, Boston, MA, comments on the unethicality of provoking psychogenic seizures to diagnose psychogenic non-epileptic seizures (PNES). Patients can be unsatisfied with their clinical experience and lose trust with their doctor. Due to the nature suggestive seizure manipulation (SSM), patients may not receive informed consent, and is not equally administered in all patients. The outcomes of SSM are often also not known, resulting in the practice not necessarily always benefiting patients. Dr Dworetzky additionally argues that timely treatment of the seizures is more important than a timely diagnosis, and that clinicians should receive better training and optimized guidelines on diagnosing PNES. This interview was conducted during the 2022 World Congress on Controversies in Neurology (CONy) meeting.