Football final game as a reason for non-epileptic convulsions: case report

Abstract

Non-epileptic convulsions, often named psychogenic non-epileptic seizures (PNES), pseudo-seizures are a relatively complex problem of unknown aetiology and prognosis. PNES are defined by modern psychiatry as a conversion disorder which is classified as one of the somatic symptoms and related disorders in DSM V and is considered a subtype of dissociative disorder in ICD 10. These disorders are diagnosed when disruptive changes in behaviour, thinking, or emotion resemble epileptic seizures, but no paroxysmal discharges are seen on electroencephalogram (EEG) and do not originate from another illness. Head trauma, sexual and physical abuse, and physical and psychological stress may also be included as factors dominating as reasons in prevalence of PNES. The golden standard for PNES diagnosis is video electroencephalogram (Video-EEG). Whereas PNES presented in women is 3:1 vs men, the treatment of PNES is still questioned: anti-epileptic medicine vs cognitive behavioural therapy (CBT). We describe a clinical case repot of a die-hard soccer fan, in which PNES manifested after the final 2018 FIFA World Cup game, where the team he was rooting for, Croatia, lost vs France.