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Diagnosis

Fits, faints, or fatal fantasy? Fabricated seizures and child abuse

M A Barber¹, P M Davis²

¹ Department of Child Health, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK
² Clinical Director of Child Health, Cardiff and Vale NHS Trust, Lansdowne Hospital, Cardiff CF1 8UL, UK

Correspondence to:
Correspondence to:
Dr P M Davis, Clinical Director of Child Health, Cardiff and Vale NHS Trust, Lansdowne Hospital, Cardiff CF1 8UL, UK;
paul.davis@cdffcom-tr.wales.nhs.uk

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Keywords: abuse; seizure; Munchausen syndrome by proxy

Abbreviations: EEG, electroencephalogram; MSbP, Munchausen syndrome by proxy

Munchausen syndrome by proxy (MSbP) is now an established form of child abuse.¹ It carries the risk of significant harm to the dependent child and siblings, with long term physical and emotional consequences for many.^2–4 It is known from retrospective studies that many cases go unrecognised for long periods and that the long term outcomes may be poor.^5–7 In many cases there have been previous sibling deaths, likely to be due to abuse.^{2, 3} The high degree of certainty that paediatricians often require before intervening has been highlighted.²

Seizures have been reported to be the most common presentation of fabricated illness. The authors' experience, mirrored by many case reports in the literature, suggests that the current threshold for the diagnosis of fabricated seizures remains too high and that abuse may continue for years before the diagnosis is made. There is a need to move towards earlier diagnosis of child abuse . . . [Full text of this article]

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This article has been cited by other articles:

• Bass, C., Adshead, G. (2007). Fabrication and induction of illness in children: the psychopathology of abuse. Adv. Psychiatr. Treat. 13: 169-177 [Abstract] [Full Text]  
• Newson, E, Le Marechal, K, David, C (2003). Pathological demand avoidance syndrome: a necessary distinction within the pervasive developmental disorders. Arch. Dis. Child. 88: 595-600 [Abstract] [Full Text]