Autonomic testing (Funkenstein test) in epileptic disorders.

Abstract

Various techniques to activate or accentuate electrical dysrhythmias are standard procedures in electroencephalograph (EEG) laboratories. On the other hand, except for research purposes, activation of emotional storms in psychiatric patients is entirely fortuitous, to be avoided whenever possible. However, during the course of autonomic nervous system testing (Funkenstein test), these fortuitous events are not unusual. The two drugs used, epinephrine and methacholine, often stimulate frank anxiety attacks or somatic symptoms, which are typical of the patient's usual complaints. Because of the apparent, albeit inconsistent, relationship between psychological phenomena and epileptic seizures, we were interested in finding out whether or not epinephrine, methacholine, or both would have the same activating effect on epileptic patients as it did on psychiatric patients. Would either drug activate sensory or psychic aurae, if not clinical seizures, as the psychiatric patient's sensory symptoms and anxiety are activated? Procedure Ten patients with different