Testing the ‘seizure scaffold’: What can experimental simulation tell us about functional seizures?, 2020, Tiefenbach, Stone et al

Andy

Retired committee member
Introduction
It has been suggested for over 100 years that patterns of neurological symptoms and signs in functional neurological disorders may be shaped at a neural level by underlying ideas or preconceptions how neurological symptoms present. This study used experimental simulation to probe ideas about seizures in healthy volunteers, with a view to compare with features commonly observed in functional and epileptic seizure disorders.

Methods
Sixty healthy volunteers were instructed to simulate an epileptic seizure. The episodes were video-recorded and assessed by three qualified markers for the presence of clinical features commonly observed in functional seizures (FS), epileptic seizures, and syncope.

Results
Simulated seizures were hyperkinetic (83%), hypokinetic (7%), or staring (10%). Fifty-two percent had their eyes open and 45% eyes closed. Tremor was observed in 70%, while clonic jerking was only present in 17%. The majority of volunteers maintained a normal or floppy body posture. Head shaking side-to-side was observed in 38%, while guttural cries, stertorous breathing, tearfulness, and hyperventilation were absent in all volunteers.

Discussion
Our results suggest that simulated seizures not only resemble FS more closely than epileptic seizures but also show some important differences. Subjective seizure experiences in people with FS, not captured by this experimental simulation, remain a core determinant of semiology.
Paywall, https://www.epilepsybehavior.com/article/S1525-5050(20)30698-3/fulltext
Sci hub, don't know why but it links to different study.

ETA: Added information about Sci Hub returning a weird result.
 
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The doi seems to be wrong, and I can't find the article in any of the usual places. It seems to be a conference abstract of some type, a brief report.

Awful, awful stuff, from what I've read so far. The definite implication is that "functional" seizures are generated from the same source, or at least a similar source, to faked seizures. Otherwise, why else draw the comparison? I'm assuming from the abstract that observer raters weren't blind to the fact that these participants were asked to fake their seizures. So they knew these were fakers, and so equated them in their minds with those "functional" people.

Seems to me a study about what ordinary people believe a seizures looks like. Nothing else.
 
The doi seems to be wrong, and I can't find the article in any of the usual places. It seems to be a conference abstract of some type, a brief report.

The DOI is correct, the materials science article that it incorrectly links to has a different DOI.
 
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Pure bilge ...I guess that some people do fake seizures (why I have no idea) but since the presentation is so varied even with seizures that have an attributable cause ..I’m not sure that this tells us anything ...perhaps they can share this with the rsc and they can use it in acting classes for episodes of casualty?
 
Who knows why people might fake seizures, perhaps for attention seeking, who knows. I would think that if the researchers really do want to investigate the pathophysiology of functional seizures, they could use tools like functional imaging - functional magnetic resonance imaging (fMRI), positron emission tomography (PET), electroencephalography (EEG), magnetoencephalography (MEG), near infrared spectroscopy (NIRS), and transcranial magnetic stimulation (TMS).

A bit more info on this paper here: https://www.rcpsych.ac.uk/docs/defa...y-2020/jakov-tiefenbach.pdf?sfvrsn=f2c9b48e_2
 
Why does it have to be explained to neurologists that people who don't work in medicine do no such thing as having:
underlying ideas or preconceptions how neurological symptoms present
What a load of crap. It's your job to think about these things. That's why YOU think about these things. NOBODY ELSE thinks about things like that, it's not a thing normal people do, having beliefs about how neurological symptoms present. STOP PROJECTING your personal perspective unto unrelated circumstances.

The level of narcissism involved in demanding that reality must conform to their personal experience of life is only outdone by the fact that otherwise smart people unrelated to those efforts look at this and think it's credible. Ugh.
 
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