Factitious Disorder Imposed on Self: Diagnostic Challenges and Clinical Lessons

Factitious disorder imposed on self (FDIS), historically known as Munchausen syndrome, is characterized by the falsification or induction of symptoms in the absence of external incentives. We report the case of a 45-year-old woman with recurrent seizure-like and anaphylaxis-like episodes across multiple hospitalizations. Video electroencephalogram (EEG), laboratory, and imaging studies were inconclusive for both seizures and anaphylaxis. Her clinical course included recurrent unexplained presentations and repeated exposure to potentially invasive interventions despite the lack of objective diagnostic confirmation. This case illustrates the diagnostic challenges of FDIS and highlights the importance of careful clinical evaluation, minimizing iatrogenic harm, and a multidisciplinary management approach.