Provocative testing for nonepileptic seizures: Attitudes and practices in the United States among American Epilepsy Society members

We sent a survey to American Epilepsy Society (AES) members about the use of provocative tests (PT) for the diagnosis of nonepileptic seizures (NES). The survey was limited to physicians practicing in the United States. Nearly 40% of the respondents routinely used PT to diagnose NES; the technique most often used was intravenous saline. The techniques most often used to stop NES were hyperventilation and suggestion alone. Respondents who routinely induced NES were more likely to consider these techniques useful than those who did not (p < 0.0001), and their patients were less Likely to have difficulty accepting the procedure than the patients of the other clinicians (p < 0.0001). Thirty-three percent of the respondents believed that the application of techniques used to induce NES posed an ethical conflict, although there was no difference in the prevalence of this attitude among respondents who did or did not routinely induce NES.