A 27 year old male came in from the psych ER for eval of seizures. He was brought in by police for psychotic behavior. The psych ER called and asked for help b/c he "was in status" and wouldn't stop seizing.
I have seen some really interesting seizures in the past. Some will even fake urinating on themselves. This guy was great. He did make his whole body shake...but the rhythm was sooo organized it was obviously not seizure activity. But the biggest issue was his face. This guy would talk to you and look at you during his "seizures." He would jerk all over, and during the shaking would say "Look...it's happening to me! This is a bad seizure huh?"
After his seizures temporarily stopped...we had a discussion about his seizure meds. He said no meds would work on him. He tried them all. Dilantin didn't work, or Keppra.......nothing in my PDR.
"Sir, what then does help you?" I said.
"There is only 1 drug that helps me. It is secretive. It is an experimental drug in phase 5 research trials" he said.
Even though I knew this guy was FOS....he had my attention. "What is the name of it?"
He said, "The name of it is called... Placebo. Placebo is the only seizure medicine that can help me. I have been off of it b/c they kicked me out of the trial. Now I am in withdrawl."
I promptly got a Tylenol tab, told him it was Placebo, watched his seizures melt away, and sent him back to the psych ER.
CHECK OUT THIS GREAT VIDEO ABOUT PATIENT FAKING A SEIZURE!!! http://www.youtube.com/watch?v=_m64cy1MMPg