[Acute consciousness disorders and epilepsy from the psychiatrist's viewpoint]

Abstract

Psychogenic loss of consciousness often leads to clinical situations where making decisions is difficult and psychiatric consultation becomes necessary. The function of the consultation/liaison-psychiatrist consists in rendering information from the psychosocial context comprehensible after establishing a first contact with the patient and his family and after the first psychiatric assessment. In a second step, the CL-psychiatrist then may make further recommendations how to deal with the patient, possibly not only in a patient-centered, but also team-centered manner. This article demonstrates a possible approach and differential diagnosis in the light of two clinical case reports. The theoretical part defines and classifies psychogenic loss of consciousness. It then deals with disorders of consciousness in epilepsy and the psychodynamics of psychogenic seizures as a subconscious expression of unbearable or unsolvable conflicts.