Provocative techniques should not be used for the diagnosis of psychogenic nonepileptic seizures

In conclusion, the use of deceptive provocative procedures in the diagnosis of NES should be discouraged. The potential benefit is small, in that eliciting a single spell is often of limited clinical utility. The possible harms, however, are great. Most importantly, such behavior endangers the physician-patient relationship, and may result in patients' failing to comply with NES treatment or seeking medical attention in the future. Furthermore, deceptive induction is inherently wrong, and should be avoided by physicians in all cases on that basis alone. Available alternative approaches that do not require deception should be employed. © 2009 Elsevier Inc. All rights reserved.