Induction of psychogenic nonepileptic seizures without placebo

The diagnosis of psychogenic nonepileptic seizures (PNES) can only be made with EEG-video monitoring. The authors describe a provocative technique without placebo. Patients with a clinical suspicion for PNES underwent an activation procedure using suggestion, hyperventilation, and photic stimulation. Of 19 inductions performed, 16 (84%) were successful in inducing the habitual episode. The authors' technique had a sensitivity comparable to those using placebo (e.g., saline injection), but does not have disadvantages.