Benjamin Tolchin, MD, is a neurologist at Yale Medicine specializing in non-epileptic seizures, particularly psychogenic seizures. These seizures look similar to epileptic ones, but without the characteristic electrical discharges associated with epilepsy. They are usually triggered by an underlying psychological condition such as severe stress or past trauma.
Dr. Tolchin went to medical school at Harvard University and completed his fellowship at Brigham and Women’s Hospital. During his residency, he developed an interest in non-epileptic seizures after seeing a patient who required a breathing tube and developed pneumonia as a result of receiving the wrong treatment.
Dr. Tolchin often sees patients referred to him from doctors who are having trouble diagnosing their seizures. He begins by determining what type of seizure the patient has by asking them numerous questions about their condition and what the seizure feels like to them. He then supplements this clinical diagnosis with a variety of tests and imaging, including videos of seizures and EEGs. “Teasing apart the different kinds of seizures and what the appropriate treatment is, is a large part of what I do,” he says.
After diagnosis, Dr. Tolchin helps patients, family and friends understand the condition and how best to manage it. “Psychogenic non-epileptic seizures can be very misunderstood,” he says. “Many people think it’s ‘all in your head,’ when it’s not.”
Once the diagnosis is made, Dr. Tolchin works with the patient and a mental health team to develop an effective treatment strategy, including anti-seizure medications for epileptic seizures, and/or psychotherapy for psychogenic seizures.
For Dr. Tolchin, being able to make a difference in his patients’ lives is the most rewarding part of his job. “When you see a life that was previously very limited suddenly blossom, that’s far and away the most important part of my work. That makes all the difference for me,” he says.