This paper aims

1. a) to explore the difficulties in differential diagnosis between epileptic crises and psychogenic non epileptic seizures (pseudoseizures),

2. b) to suggest therapeutic guidelines for psychogenic non epileptic seizures. Our purpose is to present a literature review on this subject and to discuss the problems involved.

Typical systematic review of recent articles regarding this topic at the internet search engines of PubMed and Scopus. We used the following keywords: psychogenic seizures, psychogenic non epileptic seizures (PNES), pseudoseizures, conversion disorder, dissociative disorder.

A large percentage of the seizures are found to be psychogenic non epileptic. Most of the patients are firstly treated by neurologists and only a percentage of close to 1/3 of these are referred to psychiatrists for further therapy. The differential diagnosis is difficult because most of the patients actually suffer from both epileptic and non epileptic seizures and usually come to the emergency clinics with either. Video EEG and therapeutic hypnosis are considered to be helpful techniques.

In order to treat patients suffering from psychogenic non epileptic seizures there must be a close collaboration between the neurologists, the psychiatrists and the emergency physicians considering both the medication prescribed and the therapeutic guidelines followed.