A note from a physician providing call coverage: Call from the doctor at local ED. The doctor indicates that the patient recently moved to a new group home and his usual pseudoseizures had increased in frequency and intensity. In ED, the patient was noted to be having odd movements not thought consistent with seizure, so the doctor told him that if he could calm himself, he would get him a sandwich. Movements stopped and did not return. The patient's family had come to the ED and was comfortable with the assessment that he was simply having difficulty transitioning to his new home. They only asked that his pediatric neurologist be informed. Aside from recommending sandwiches for everyone involved, I made no new recommendations but would inform his pediatric neurologist of these events.
The pediatric neurologist upon being informed indicated: My new rescue plan: If the seizure movements continue for 3 minutes, administer half a hoagie. If the spell continues for 5 more minutes give the other hoagie half and call for pizza delivery