Neurologist here. While I hesitate to say this patient isn’t malingering, I believe that it’s important to note that psychogenic non-epileptic seizures are rarely caused by “faking.” They are generally a manifestation of overwhelming anxiety, and should be treated as such; mental illness is just as real as physical illness. A nurse thought I was faking that I could not swallow when I woke up from jaw surgery. When I came out of the surgery and was panicking telling them I couldn’t swallow my own saliva, the nurse just told me “yes, you can. This surgery wouldn’t have anything to do with your ability to swallow.” I could also barely speak and started crying and pleading with her to believe me.
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I could kind of walk but my hips hurt. I keep telling them but they just gave them a simple squeeze and thought it was fine since my response was ‘Ouch, that hurts’ instead of screaming in pain. I got a scan and they checked the baby’s heart rate and all looked fine, but instead of keeping me in for observation, they sent me home with Tylenol. Turned out I was in shock (surprise) and the adrenaline dulled my pain reactions or something. Also turned out I had a fractured pelvis, three broken ribs, and massive internal bleeding – that they would have seen after a few hours because of the bruising and my blood pressure.