Q.My wife has been suffering from seizures. They seemed to be related to epilepsy, and she has been hospitalized four times with no solution in sight. The seizures are atypical in duration and type, and her behavior before, during and after them is inconsistent with a seizure disorder. For example, her eyes remain normal and do not constrict or dilate. Someone suggested Munchausen’s syndrome may be the cause. Do you think this could be so? I know there was some physical/sexual abuse in a previous relationship when she was 18, but I do not know of any as a child.

Michael

A. I can’t say for sure what is causing — or is related to — your wife’s seizures without evaluating her personally. But it sounds as though someone — whether a medical or mental health professional, I don’t know — is wondering whether your wife’s seizures are psychological in origin.

You say the seizures “seem to be related to epilepsy” but are atypical. Since she’s been hospitalized four times, I’ll assume that EEGs have been performed and anticonvulsant medication has been tried without much success. It is true that people can have seizures of nonepileptic origin, sometimes called pseudoseizures, and some people fake seizures outright (almost any condition can be faked, at least behaviorally). Some of those people might be considered to have Munchausen’s syndrome (called “factitious disorder” in the current psychiatric diagnostic manual), or be flat-out faking for some kind of secondary gain. (For more detail on Munchausen’s syndrome, see my earlier column on this topic.)

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