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Psychogenic Seizures

Kenichiro Sato, Noritoshi Arai, Aki Omori, Ayumi Hida, Akio Kimura, Sousuke Takeuchi
PURPOSE: Hyperammonaemia is frequently observed in patients who have experienced convulsive seizures. Although excessive muscle contraction is presumed to be responsible for the elevated levels of ammonia, the underlying mechanism is poorly understood. The present study aimed to identify the independent factors associated with ammonia elevation using large-scale multivariate analysis. METHODS: We conducted a cross-sectional study involving 379 adult patients who had been transported to our emergency department and treated for unprovoked convulsive seizures between August 2010 and September 2015...
October 6, 2016: Seizure: the Journal of the British Epilepsy Association
Benjamin Johnstone, Dennis Velakoulis, Cheng Yi Yuan, Anthony Ang, Chris Steward, Patricia Desmond, Terence J O'Brien
OBJECTIVE: Exposure to early life childhood trauma has been implicated as resulting in a vulnerability to epileptic and psychogenic nonepileptic seizures (PNES), hippocampal atrophy, and psychiatric disorders. This study aimed to explore the relationships between childhood trauma, epilepsy, PNES, and hippocampal volume in patients admitted to a video-electroencephalogram monitoring (VEM) unit. METHODS: One hundred thirty-one patients were recruited from the Royal Melbourne Hospital VEM unit...
October 12, 2016: Epilepsy & Behavior: E&B
Teng-da Xu, Sheng-Yong Xu, Jia-Yuan Dai
No abstract text is available yet for this article.
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
Benjamin Tolchin, Gaston Baslet, Barbara Dworetzky
No abstract text is available yet for this article.
October 7, 2016: Epilepsy & Behavior: E&B
Hamada H Altalib, Khalid Elzamzamy, Mary Jo Pugh, Javier Ballester Gonzalez, Kei-Hoi Cheung, Brenda T Fenton, Robert D Kerns, Cynthia A Brandt, W Curt LaFrance
Management of psychogenic nonepileptic seizures (PNES) requires collaboration among and between health care professionals. Although criteria are established for diagnosis of PNES, miscommunication between neurologists, primary care providers, and mental health professionals may occur if the clinical impression is not clearly articulated. We extracted progress notes from the Department of Veterans Affairs (VA) electronic health record (EHR) nationally to study veterans who were evaluated for PNES. Of the 750 patients being worked up for PNES, the majority of patients did not meet criteria for PNES (64...
October 7, 2016: Epilepsy & Behavior: E&B
Ali A Asadi-Pooya, Marjan Asadollahi, Krzysztof Bujarski, Amin H Rabiei, Narsis Aminian, Dale Wyeth, Michael R Sperling
PURPOSE: Ictal verbal help-seeking has never been systematically studied before. In this study, we evaluated a series of patients with ictal verbal help-seeking to characterize its frequency and underlying etiology. METHODS: We retrospectively reviewed all the long-term video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the term "help" in the text body. All the extracted reports were reviewed and patients with at least one episode of documented ictal verbal help-seeking in epilepsy monitoring unit (EMU) were studied...
October 7, 2016: Epilepsy & Behavior: E&B
Ali A Asadi-Pooya, Jennifer Tinker, Elizabeth Fletman
PURPOSE: We classified patients with psychogenic nonepileptic seizures (PNESs) according to a newly proposed classification system. Then, we investigated the demographic and clinical differences between various classes of the patients. METHODS: We retrospectively investigated all patients with PNESs admitted to the Jefferson Comprehensive Epilepsy Center from 2012 through 2016. We classified the patients into four distinct classes: patients with generalized motor seizures, patients with akinetic seizures, patients with focal motor seizures, and patients with seizures with subjective symptoms...
October 7, 2016: Epilepsy & Behavior: E&B
J Gelauff, J Stone
The prognosis of functional (psychogenic) neurologic disorders is important in being able to help answer patients' and carers' questions, determine whether treatment is worthwhile, and to find out which factors predict outcome. We reviewed data on prognosis of functional neurologic disorders from two systematic reviews on functional motor disorders and dissociative (nonepileptic) seizures as well as additional studies on functional visual and sensory symptoms. Methodologic problems include heterogeneity in studied samples and outcome measures, diagnostic suspicion and referral bias, small size and retrospective design of available studies, possible treatments during follow-up, and literature review bias...
2017: Handbook of Clinical Neurology
C Bass, P Halligan
Interest in malingering has grown in recent years, and is reflected in the exponential increase in academic publications since 1990. Although malingering is more commonly detected in medicolegal practice, it is not an all-or-nothing presentation and moreover can vary in the extent of presentation. As a nonmedical disorder, the challenge for clinical practice remains that malingering by definition is intentional and deliberate. As such, clinical skills alone are often insufficient to detect it and we describe psychometric tests such as symptom validity tests and relevant nonmedical investigations...
2017: Handbook of Clinical Neurology
R Duncan
In the investigation of psychogenic nonepileptic seizures (PNES), the main differential diagnoses are between convulsive PNES and tonic-clonic seizures, between swoon PNES and syncope, and between pseudoabsence PNES and absence seizures. For the best diagnostic certainty, events must be captured, ideally using video-electroencephalogram (EEG), including an electrocardiographic channel. The "video" part of video-EEG allows EEG changes (or lack of them) to be interpreted in the appropriate clinical context. When the diagnosis is based on less good data (e...
2017: Handbook of Clinical Neurology
W Curt Lafrance, R Ranieri, A S Blum
This chapter describes the evaluation process for the diagnosis of psychogenic nonepileptic seizures (PNES), which is determined based on concordance of the composite evidence available, including historic and physical exam findings, seizure semiology, and ictal/interictal electroencephalogram (EEG). No single clinical feature is pathognomonic of PNES. The diagnosis of PNES can be at times challenging, such as when seizure documentation on video-EEG cannot be readily achieved. A multicomponent approach to the diagnosis of PNES, with use of all available evidence, may facilitate diagnosis and then care of patients with PNES...
2017: Handbook of Clinical Neurology
M Reuber, G H Rawlings
Psychogenic nonepileptic seizures (PNES) superficially resemble epileptic seizures or syncope and most patients with PNES are initially misdiagnosed as having one of the latter two types of transient loss of consciousness. However, evidence suggests that the subjective seizure experience of PNES and its main differential diagnoses are as different as the causes of these three disorders. In spite of this, and regardless of the fact that PNES are considered a mental disorder in the current nosologies, research has only given limited attention to the subjective symptomatology of PNES...
2017: Handbook of Clinical Neurology
C Gasca-Salas, A E Lang
The diagnosis of functional neurologic disorders can be challenging. In this chapter we review the diagnostic criteria and rating scales reported for functional/psychogenic sensorimotor disturbances, psychogenic nonepileptic seizures (PNES) and functional movement disorders (FMD). A recently published scale for sensorimotor signs has some limitations, but may help in the diagnosis, and four motor and two sensory signs have been reported as highly reliable. There is good evidence using eight specific signs for the differentiation of PNES from seizures...
2017: Handbook of Clinical Neurology
Oliver T R Toovey, Ian R Edmond, Nikolaos Makris
A 47-year-old woman presented with seizures secondary to euvolaemic hyponatraemia. A collateral history revealed recent increased oral fluid intake and increased use of herbal remedies including valerian root over the New Year period. There was no history of psychiatric disease to support psychogenic polydipsia. She responded to careful sodium replacement in the intensive care unit and was discharged with no neurological sequelae.
2016: BMJ Case Reports
Brian D Moseley, Sandra Dewar, Zulfi Haneef, Dawn Eliashiv, John M Stern
Epilepsy monitoring unit (EMU) admissions are essential for the classification/localization of epileptic seizures (ES) and psychogenic non-epileptic seizures (PNES). However, the duration of admissions is highly variable. Accordingly, we evaluated the duration of 596 EMU admissions and reasons for prolonged (>7 days) lengths of stay (LOS). The average LOS was longer for patients diagnosed with ES (8.0 days, SD 4.1 days) than all others (6.0 days, SD 3.9 days, p<0.001). Of the 596 admissions, 231 (38.8%) had prolonged LOS...
September 1, 2016: Epilepsy Research
Marlena Hupalo, Janusz W Smigielski, Dariusz J Jaskolski
PURPOSE: To find the optimal duration of the long-term video-EEG (LTM) and assess diagnostics utility of LTM in patients with epilepsy and other paroxysmal events in terms of future diagnosis and management. METHODS: Retrospective analysis of 282 LTMs performed in the last 5 years in our Epilepsy Monitoring Unit (EMU), in 202 consecutive patients. The analysis included demographic data, monitoring time, number and type of paroxysmal events, the time until their onset, influence of LTM result on the diagnosis and future management...
2016: Neurologia i Neurochirurgia Polska
Jessica J Falco-Walter, Michael Stein, Maggie McNulty, Lubov Romantseva, Peter Heydemann
We report a 10-year-old boy with mild developmental delay and epilepsy with new events of right back tickling and emotional upset. These initially appeared behavioral, causing postulation of habit behaviors or psychogenic nonepileptic seizures. Several ictal and interictal EEGs were unrevealing. Continuous EEG revealed only poorly localized frontal ictal activity. Given that his clinical symptoms suggested a parietal localization, double-density EEG electrodes were placed to better localize the epileptogenic and symptomatogenic zones...
2016: Epilepsy & Behavior Case Reports
Roman Rutka, Anne Denis, Laurent Vercueil, Pascal Hot
Psychogenic nonepileptic seizures (PNES) are paroxysmal attacks that can imitate epileptic seizures but do not have a neurological origin. There has been mounting interest these last few years to unravel psychological and neuronal factors that contribute to the development of PNES. The objective of this review is twofold. First, we examine recent contributions of clinical and researches studies to define the main features of PNES. Then, we focus on the possible link between changes in processing of emotional information and the onset of PNES...
2016: Santé Mentale Au Québec
Josef Finsterer, Lässer Stefan
Malingering and factitious disorder (Münchausen-syndrome) has not been reported as a manifestation of a mitochondrial-disorder (MID). Here, we report a 46 years-old female with a MID due to a combined complex I-IV defect, manifesting in the cerebrum, muscle, bone marrow, kidneys, and the endocrine glands. Myopathy showed up as myalgia, easy fatigability, ptosis, and abnormal muscle biopsy. Endocrine involvement manifested as short stature and thyroid dysfunction. Involvement of the kidneys manifested as mild Fanconi syndrome...
July 2016: Indian Journal of Psychological Medicine
Andreu Massot-Tarrús, Richard S McLachlan
OBJECTIVES: Epidemiologic evidence supporting antiseizure properties of cannabis is limited and controversial. We determined the prevalence of marijuana use and its perceived effects in patients with and without epilepsy. METHODS: Information was collected over 14months from consecutive adult patients admitted to an epilepsy monitoring unit using a 27-item anonymous questionnaire. Patients with cognitive impairment unable to understand the questions or give informed consent and readmissions were not recruited...
October 2016: Epilepsy & Behavior: E&B
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