Stertorous breathing is a reliably identified sign that helps in the differentiation of epileptic from psychogenic non-epileptic convulsions: an audit.

Stertorous breathing may occur after epileptic convulsions, but does not typically occur after psychogenic non-epileptic convulsions. During an 18-month audit at a tertiary referral centre in the United Kingdom, we analysed 75 convulsions arising in 45 patients and found that nursing and ancillary staff can be easily trained to reliably identify the presence or absence of stertorous breathing after a convulsion. No patient with a final diagnosis of purely psychogenic non-epileptic seizures (17 out of 45 patients) was judged to have stertorous respiration. Stertorous breathing was present in 41 out of 44 interpretable video recordings from patients with epileptic convulsions proven on videotelemetry. We suggest that a history or evidence (e.g. video) of stertorous breathing may help in distinguishing epileptic from psychogenic non-epileptic convulsive seizures.