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Tongue biting in pseudoseizures and epilepsy

¹ Consultant Neurologist, Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
² Consultant Neurologist, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK

Correspondence to:
Correspondence to:
Dr J Stone, Department of Clinical Neurosciences, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK; Jon.Stone@ed.ac.uk

The first 150 words of the full text of this article appear below.

We enjoyed Fuller and Lindahl’s article about clinical clues for distinguishing epilepsy from non-epileptic attacks.1 Their comments about the location of tongue biting in non-epileptic attacks (rarely the side, sometimes the tip) may well be correct, but we thought they deserved some additional comment, partly because their analysis omitted a number of relevant studies (see table).2–12 We have combined the mainly small series in the table, admittedly inviting a host of methodological problems. What this literature shows though is that when non-specific "tongue biting" is recorded it isn’t a useful discriminator. Only the Benbadis study6 looked at whether the tip or the side of the tongue was bitten—something that this single study suggests is a highly specific discriminator. In addition, the data may mask differences between the patients who give a history of tongue biting and the patient who shows you a bitten tongue.

So, on . . . [Full text of this article]