<prompt> In a youngster with a history of seizures, which of the following would be most suggestive of a nonorganic or hysterical etiology:Postictal sleepChanging pattern of the seizureBiting of the tongue during an episodeUrinary incontinence during an episode  <response>: Hysterical episodes stimulating seizures rarely are associated with bodily injury, incontinence, or postictal sleep. The pseudoseizures frequently are triggered by bizarre stimuli, and the pattern of the seizure changes often. The patient actually is awake and aware of his or her surroundings and events and can recall them later. Pseudoseizures usually can be distinguished both clinically and by the electroencephalogram EEG findings. In patients with pseudoseizures resembling tonic-clonic attacks, there may be warning and preparation before the attack; there is usually no tonic phase, and the clonic phase consists of wild thrashing movements during which the patient rarely comes to harm or is incontinent. Ictal eye closure is common. In some instances, there are abnormal movements of all extremities without loss of consciousness; in others, there is shouting, uttering of obscenities, or goal-directed behavior during apparent loss of consciousness. There is no postictal confusion or abnormal clinical signs after the attack. The EEG, if recorded during an episode, does not show organized seizure activity, and postictal slowing does not occur. Ref: Greenberg D.A., Aminoff M.J., Simon R.P. 2012. Chapter 12. Seizures Syncope. In D.A. Greenberg, M.J. Aminoff, R.P. Simon Eds, Clinical Neurology, 8e. 