To the Editor:

I agree with Dr. Benbadis.¹ There is no advantage to keeping the word “seizures” in the phrase “psychogenic nonepileptic seizures.” But I also disagree with using the word “attack.” Who wants to have an attack?

In addition, telling patients that they have “psychogenic” seizures can be deleterious to the patient–physician relationship.

I think that the best term to use is “nonepileptic spells.” It is short, simple, and does not have a negative connotation.

To the Editor:

We read the articles by Drs. Benbadis¹ and LaFrance² with great interest. They consider removing the word “seizures” from the phrase “psychogenic nonepileptic seizures.”

Dr. Benbadis contends that this word leads to unnecessary confusion in patients and caregivers while Dr. LaFrance makes a spirited defense for retaining the term. Dr. LaFrance argues that a seizure is not synonymous with an epileptic attack. Patients with psychogenic nonepileptic events are exceedingly hard to cure and they often reject their diagnosis. As a result, many are lost to follow-up.

It has been reported that a substantial minority of patients became spell-free with communication of the diagnosis as the only intervention. Many patients stopped using emergency services, regardless of whether spells continued.³ Communication is key: telling patients that they do not have seizures may take away their false sense of security and may alienate them.

In our experience, informing patients that they have seizures—but not of epileptic origin—fosters trust between the patient and the physician. This good will makes the patient more amenable to seeing a psychiatrist for cognitive behavioral therapy.

To the Editor:

Not only is the term “seizures” …