Tuesday, February 2, 2010

And the award for best actress in a hospital gown goes to...

This morning I did a hospital consult on a psychiatric patient with pseudo-seizures.

While I was talking to her she suddenly yelled the dreaded "Oh no! You're making me have a seizure! Here it comes!"

This was followed by a an acting job with yelling, thrashing, and moaning that looked more like Meg Ryan's famous deli scene from "When Harry Met Sally" then any kind of epilepsy I've ever seen.

"Oh God! Oh my God! Oh my God! I'm having a seizure! I'm seizing! Oh! Oh! Oh!"

After it was over she opened her eyes and said "Did you think I was having a seizure?"

I thought about telling her what I really thought she was having, but decided to keep my mouth shut.
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22 comments:

  1. instant studentFebruary 2, 2010 at 7:45 AM

    Haha, maybe you should have told her.
    Might have been the cure. :)

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  2. J-Quell'nFebruary 2, 2010 at 8:02 AM

    One usually does not shout "I'm having a seizure!" when one is actually having a seizure, correct?

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  3. Grumpy, M.D.February 2, 2010 at 8:06 AM

    Jacqueline- generally not, though there are exceptions.

    This one, however was definitely NOT real.

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  4. webhillFebruary 2, 2010 at 8:42 AM

    people are so weird. at least my patients do not generally fake seizures ;). I did have a dog patient whose seizure disorder was hard to diagnose at first - his seizures involved very ataxic walking backwards across the room!

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  5. SaraFebruary 2, 2010 at 8:54 AM

    You have to watch this. It's a patient faking a seizure, too funny.

    http://www.youtube.com/watch?v=_m64cy1MMPg

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  6. CelesteFebruary 2, 2010 at 9:21 AM

    I wonder if she fakes her orgasms as badly as she fakes her seizures.

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  7. instant studentFebruary 2, 2010 at 9:55 AM

    @ Celeste: Maybe she confused both shows...

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  8. terri cFebruary 2, 2010 at 10:41 AM

    I wonder if rectal manipulation would cure her seizure. You'd have to refer her for that of course...

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  9. mommanatorFebruary 2, 2010 at 10:42 AM

    Now how do you maintain that descretion!

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  10. C.February 2, 2010 at 11:06 AM

    Well when you said she was a psych patient, I just figured it was going to be a good story.

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  11. danielleFebruary 2, 2010 at 12:38 PM

    I want to know if you yawned your answer at her? Or jsut stood leaning against the wall, with your arms crossed, and a very pathetic round of hand clapping when she was done??? At least in your mind that is....

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  12. student dr. blazeFebruary 2, 2010 at 4:16 PM

    I'm laughing so hard, I almost sprayed diet coke all over my MacBook. The guy mopping the cafe is looking at me like I'm the psycho patient. If he asks, I'll tell him Dr. Grumpy made me do it. ;-)

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  13. Chrysalis February 2, 2010 at 4:56 PM

    Oh brother....

    I love the comments. They make me laugh as much as your posts do. These guys and gals are the best.

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  14. Grumpy, M.D.February 2, 2010 at 4:58 PM

    Danielle- I told her it didn't look like epilepsy, and I'd discuss it with her other doctors (translation- I'm calling your psychiatrist).

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  15. stewbertFebruary 2, 2010 at 7:48 PM

    oh wow ... i think you should have told her, too. haha

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  16. AnonymousFebruary 2, 2010 at 9:17 PM

    So was the diagnosis "Attention Whore"?

    Monkeys have more sense.

    LD50 Rat

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  17. Just CuriousFebruary 2, 2010 at 11:48 PM

    So, what do seizure fakers in general (not just this particular psych patient) hope to gain by pulling the wool over an MD's eyes?

    Benzos, barbiturates, tranks, narcotics, sympathy, something more, something less, all of the above, none of the above?

    Changing subjects, sort of, when y'all refer to "migraineurs" is that another way of saying malingerer using migraine as a pretext?

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  18. Grumpy, M.D.February 3, 2010 at 6:20 AM

    Just Curious- migraneur is a medical term for a patient with migraines. It doesn't connote anything beyond that.

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  19. Mark p.s.2February 3, 2010 at 7:58 AM

    From this description I think she was having an orgasm (if her body muscles actually spasmed). You should have told her. Unconscious-subconscious fear made real through a feedback loop of fear of having an orgasm-seizure.
    It could be natural or from SSRI's or whatever drugs she was taking.
    LINK

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  20. RiverFebruary 4, 2010 at 3:06 AM

    Obviously she's never seen a seizure happening, or she'd be better informed.

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  21. AnonymousFebruary 17, 2010 at 1:07 AM

    An ambulance brought me a guy having a reasonably good-looking seizure in the ER. I ordered 2 mg of Ativan right as his very concerned-looking fiancee showed up, so I ask her "so, he has seizures?" and she very ernestly tells me "oh yes. He has pseudoseizures!"

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  22. AnonymousFebruary 27, 2010 at 1:58 PM

    We used to refer to that as Status Dramaticus. AD has an entry about a full day of it.


    ambulancedriverfiles.com/?feb_network_search_context=blog&s=status+dramaticus

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So wadda you think?