The authors describe the case-history of a girl where from the age of 4 years partial simple paroxysms were manifested which originated in the occipital lobe, had a trend of occasional generalizations, and it did not prove possible to compensate them completely by antiepileptic treatment. After the age of 10 years numerous polymorphous complaints came to the foreground, in particular attacks of sickness or misty vision, possibly states of further areactivity. The case-report indicates that psychogenically conditioned paroxysms may have a negative impact on the quality of the patient’s life and the life of his family. It emphasizes the necessity of a quite individual diagnostic and subsequent psychotherapeutic approach to every patient. In the discussion the authors try to offer a more comprehensive approach to the diagnosis and treatment of psychogenically conditioned paroxysms, based on the binary principle of a conscious – non-conscious state, i.e. from a somewhat different aspect than usually reported in the literature.

        Key words: epilepsy, non-epileptic paroxysms, psychogenic paroxysms, conscious and non-conscious state, video EEG