ABSTRACT
OBJECTIVE: Nonepileptic attacks (NEAs) pose diagnostic and therapeutic uncertainties. Prognosis is poor. Activation procedures like saline infusion have been used for diagnostic purposes. METHOD: We reviewed 66 consecutive patients with a probable diagnosis of NEA. During the EEG an attempt was made to induce an attack with verbal suggestion and saline infusion. Patients were followed up with a postal or telephone questionnaire 4.5 years after the EEG. RESULTS: Saline infusion with verbal suggestion induced in 41 of 66 patients a NEA, i.e., a positive test. Thirty-one patients were followed up. Attacks were reduced in 20 patients, of whom 12 were attack-free. More patients were attack-free at follow-up after a positive (7 of 16) in comparison to a negative (5 of 15) test. CONCLUSION: A provocative test can be diagnostic in some patients with NEA. An early and firm diagnosis may lead to appropriate treatment and better outcome.
