Psychogenic status epilepticus

A patient was brought to the Emergency Department in presumed status epilepticus. However, the seizure had many of the clinical characteristics that, in combination, were suggestive of a psychogenic event including asynchronous extremity movements, forward pelvic thrusting, and geotrophic eye movements. An arterial blood gas and serum electrolytes were normal despite one-half hour of tonic-clonic activity, and supported the diagnosis of a nonneurogenic event. The patient became conversant toward the end of the event, which confirmed that the seizure was nonepileptogenic.