ictal eye closure = pseudoseizures

Ictal eye closure is a reliable indicator for psychogenic nonepileptic seizures

Steve S. Chung, MD, Paula Gerber, MD and Kristin A. Kirlin, PhD

From the Departments of Neurology (S.S.C., P.G.) and Clinical Neuropsychology (K.A.K.), Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ.

Address correspondence and reprint requests to Dr. Steve S. Chung, Department of Neurology, 500 West Thomas Road, Suite 300, Phoenix, AZ 85013; e-mail: sschung@chw.edu

Using data from video-EEG monitoring, the authors studied whether ictal eye closure was a reliable indicator of psychogenic nonepileptic seizures (PNES). Among the 52 patients with PNES, 50 consistently closed their eyes, while 152 of the 156 patients with epileptic seizures (ES) opened their eyes during seizures. These findings suggest that ictal eye closure is a highly reliable indicator for PNES, while ictal eye opening is an indicator of ES.

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