Fictitious epilepsy in Munchausen syndrome by proxy: family psychodynamics.

This paper presents experience of Munchausen Syndrome by Proxy in four families where symptoms and signs of seizures in children were deliberately fabricated or induced by their own parent. At the time when the condition was suspected, the children (5, 7, 13 and 14 years old) had already been exposed to numerous investigations and antiepileptic drug intake-in one case resulting in drug intoxication. The important data, giving clues about how to uncover the condition, are peculiar to each family. After the condition was confirmed, a multidisciplinary team organized an approach aimed at protecting the abused child and changing the pathological parent-child relationship. Personality disorders were recognized in all illness perpetrators (the father in one and the mother in three families) and various psychopathological manifestations were present in all of the abused children. Psychodynamic factors causing the Manchausen Syndrome by Proxy are described and discussed.