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Psychogenic Seizures

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https://www.readbyqxmd.com/read/29132064/patients-and-caregivers-contributions-for-differentiating-epileptic-from-psychogenic-nonepileptic-seizures-value-and-limitations-of-self-reporting-questionnaires-a-pilot-study
#1
Giuseppe Erba, Elisa Bianchi, Giorgia Giussani, John Langfitt, Adam Juersivich, Ettore Beghi
PURPOSE: Questionnaires investigating semiology and comorbidities of psychogenic non-epileptic seizures (PNES) have been used mainly to help physicians expedite referrals to epilepsy centres for confirmation of diagnosis rather than as alternative diagnostic tool when video-EEG monitoring (VEM), the current gold standard, is not available or is inconclusive. METHODS: We developed one structured questionnaire for patients, exploring subjective experiences and vulnerabilities and one for eyewitnesses, focused on features observable during typical events to study prospectively 50 consecutive adult patients with PNES or epileptic seizures (ES) admitted for VEM...
November 8, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29111503/are-the-clinical-classifications-for-psychogenic-nonepileptic-seizures-reliable
#2
Coline Duwicquet, Bertrand de Toffol, Philippe Corcia, Maxime Bonnin, Wissam El-Hage, Julien Biberon
BACKGROUND: Psychogenic nonepileptic seizures (PNESs) are episodes that resemble epileptic seizures but are of psychological origin. A few studies have attempted to describe different types of PNES as a combination of clinical signs but their validation and robustness have not yet been reached. The aim of this study was to assess the inter-rater reliability (IRR) of five existing clinical PNES classifications. METHODS: A total of 107 PNESs from 54 patients were retrospectively analyzed independently by two trained epileptologists, who were blinded to each other's findings...
October 27, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29111502/a-simple-clinical-score-for-prediction-of-nonepileptic-seizures
#3
Sindhu R Rao, Jeremy D Slater, Giridhar P Kalamangalam
Psychogenic nonepileptic seizures (PNES), often mistaken for epilepsy in community practice, require inpatient video-EEG (VEEG) monitoring for diagnostic confirmation. We developed a simple score designed for use in an outpatient setting to predict the subsequent VEEG diagnosis of PNES. We retrospectively compared fifty-five consecutive patients with VEEG-proven PNES (N1=55) with a group of randomly selected patients with VEEG-proven epilepsy (N2=55). Patients were divided into two groups: I) a 'truly retrospective' group of 27 patients with PNES and 27 patients with epilepsy whose data served to develop the score, and II) a 'pseudoprospective' group of 28 patients each with PNES and epilepsy to whom the score was applied...
October 27, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29111501/understanding-variability-in-driving-recommendations-for-patients-with-seizures
#4
Sidrah Mahmud, Sean T Hwang
BACKGROUND: There is lack of consensus regarding driving restrictions for patients with epilepsy. Regulations vary by state. New York State (NYS) recommends driving restrictions for one year in a person with an episode of loss of consciousness (LOC), with physician discretion. Often, providers make recommendations to permit their patients to drive after a shorter seizure-free period than proposed guidelines. The prevalence and reasons behind more lenient recommendations have not been elucidated...
October 27, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29092782/psychopathological-constellation-in-patients-with-pnes-a-new-hypothesis
#5
Iolanda Martino, Antonella Bruni, Angelo Labate, Roberta Vasta, Antonio Cerasa, Giuseppe Borzì, Pasquale De Fazio, Antonio Gambardella
Depression symptoms have often reported in patients with psychogenic nonepileptic seizures (PNES), although the underlying psychopathological symptomatology has been poorly understood. Our aim was to compare constellations of psychological and behavioral disturbance in PNES with respect to patients with mild-major depressive disorder (MDD), hypothesizing that the construct of depression might be different in the two groups. Ten patients with PNES and ten sex-/age-matched patients with mild-MDD newly-diagnosed, were enrolled in this study...
October 29, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29055272/engaging-psychiatrists-in-the-diagnosis-of-psychogenic-nonepileptic-seizures-what-can-they-contribute
#6
Massimiliano Beghi, Giuseppe Erba, Cesare Maria Cornaggia, Giorgia Giussani, Elisa Bianchi, Gianni Porro, Michela Russo, Ettore Beghi
PURPOSE: To investigate if psychiatrists could predict the diagnosis of psychogenic nonepileptic seizures (PNES) by reviewing videos of seizures of various types and to compare the accuracy and the criteria leading to the diagnosis used by psychiatrists with those used by epileptologists. METHODS: Four board-certified psychiatrists were asked to review 23 videos capturing representative events of 21 unselected consecutive patients admitted to an epilepsy center for long-term video-EEG monitoring...
October 16, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29054498/erratum-to-psychogenic-nonepileptic-seizures-namibian-healthcare-providers-perceptions-and-frustrations-seizure-50-2017-43-52
#7
Anina du Toit, Chrisma Pretorius
No abstract text is available yet for this article.
October 17, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29049948/altered-responsiveness-in-psychogenic-nonepileptic-seizures-and-its-implication-to-underlying-psychopathology
#8
Gaston Baslet, Benjamin Tolchin, Barbara A Dworetzky
PURPOSE: Altered responsiveness during psychogenic nonepileptic seizures (PNES) is a distinct semiological feature that may signal a psychological vulnerability. We hypothesized that altered responsiveness is related to difficulties with emotion tolerance, experiential avoidance, difficulty coping, dissociation and trauma and prior experiences of loss of awareness. METHODS: 71 patients with video-EEG confirmed PNES were divided into two groups based on their responsiveness at the time of the captured event during long-term monitoring...
October 13, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29034101/lamotrigine-induced-sexual-dysfunction-and-non-adherence-case-analysis-with-literature-review
#9
Kenneth R Kaufman, Melissa Coluccio, Kartik Sivaraaman, Miriam Campeas
BACKGROUND: Optimal anti-epileptic drug (AED) treatment maximises therapeutic response and minimises adverse effects (AEs). Key to therapeutic AED treatment is adherence. Non-adherence is often related to severity of AEs. Frequently, patients do not spontaneously report, and clinicians do not specifically query, critical AEs that lead to non-adherence, including sexual dysfunction. Sexual dysfunction prevalence in patients with epilepsy ranges from 40 to 70%, often related to AEDs, epilepsy or mood states...
September 2017: BJPsych Open
https://www.readbyqxmd.com/read/28971651/-utility-of-inpatient-long-term-video-eeg-monitoring
#10
Moshe Herskovitz, Yitzhak Schiller
INTRODUCTION: Ambulatory interictal EEG cannot always clarify the nature of spells in patients with suspected epilepsy. Long term Video EEG Monitoring can help to diagnose the nature of recurrent attacks, classify epileptic seizures and aid with the localization of seizures in preoperative epilepsy surgery candidates. OBJECTIVES: The aim of this study was to investigate the usefulness of performing long term video EEG monitoring in patients undergoing this test in Rambam's epilepsy unit...
September 2017: Harefuah
https://www.readbyqxmd.com/read/28956479/psychogenic-non-epileptic-seizures-in-children-and-adolescents-part-ii-explanations-to-families-treatment-and-group-outcomes
#11
Kasia Kozlowska, Catherine Chudleigh, Catherine Cruz, Melissa Lim, Georgia McClure, Blanche Savage, Ubaid Shah, Averil Cook, Stephen Scher, Pascal Carrive, Deepak Gill
Psychogenic non-epileptic seizures (PNES) - time-limited disturbances of consciousness and motor-sensory control, not accompanied by ictal activity on electroencephalogram (EEG) - are best conceptualized as atypical neurophysiological responses to emotional distress, physiological stressors and danger. Patients and families find the diagnosis of PNES difficult to understand; the transition from neurology (where the diagnosis is made) to mental health services (to which patients are referred for treatment) can be a bumpy one...
September 1, 2017: Clinical Child Psychology and Psychiatry
https://www.readbyqxmd.com/read/28956448/psychogenic-non-epileptic-seizures-in-children-and-adolescents-part-i-diagnostic-formulations
#12
Kasia Kozlowska, Catherine Chudleigh, Catherine Cruz, Melissa Lim, Georgia McClure, Blanche Savage, Ubaid Shah, Averil Cook, Stephen Scher, Pascal Carrive, Deepak Gill
Psychogenic non-epileptic seizures (PNES) are a nonspecific, umbrella category that is used to collect together a range of atypical neurophysiological responses to emotional distress, physiological stressors and danger. Because PNES mimic epileptic seizures, children and adolescents with PNES usually present to neurologists or to epilepsy monitoring units. After a comprehensive neurological evaluation and a diagnosis of PNES, the patient is referred to mental health services for treatment. This study documents the diagnostic formulations - the clinical formulations about the probable neurophysiological mechanisms - that were constructed for 60 consecutive children and adolescents with PNES who were referred to our Mind-Body Rehabilitation Programme for treatment...
September 1, 2017: Clinical Child Psychology and Psychiatry
https://www.readbyqxmd.com/read/28927714/differentiating-pnes-from-epileptic-seizures-using-conversational-analysis
#13
Costanza Papagno, Lorenzo Montali, Katherine Turner, Alessandra Frigerio, Martina Sirtori, Elena Zambrelli, Valentina Chiesa, Maria Paola Canevini
We applied conversation analysis in an unselected continuous series of 70 patients to discriminate patients with psychogenic nonepileptic seizures (PNES) from patients with epilepsy. Two psychologists examined the patients' recorded reports. Patients were also submitted to an extensive neuropsychological battery in order to verify whether specific cognitive deficits or mental health problems are typical of patients with PNES and whether some cognitive deficits could prevent the correct diagnosis. The results showed a good percentage of correct diagnosis, with a sensitivity of 0...
September 15, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28927333/vulnerability-to-psychogenic-non-epileptic-seizures-is-linked-to-low-neuropeptide-y-levels
#14
Michael Winterdahl, Alessandro Miani, Moana J H Vercoe, Antonia Ciovica, Lori Uber-Zak, Charlotte Ulrikka Rask, Paul J Zak
Psychogenic non-epileptic seizures (PNES) is a conversion disorder that reflects underlying psychological distress. Female patients with PNES often present with a history of prolonged stressors, especially sexual abuse. In the current study, we studied the relationship between neuropeptide Y (NPY) and PNES symptoms in women with a history of sexual abuse. NPY has been associated with resilience to stress and we hypothesized that low levels would increase the extent and severity of PNES symptoms in this patient population...
September 19, 2017: Stress: the International Journal on the Biology of Stress
https://www.readbyqxmd.com/read/28926747/ictal-source-imaging-and-electroclinical-correlation-in-self-limited-epilepsy-with-centrotemporal-spikes
#15
Jørgen Alving, Martin Fabricius, Ivana Rosenzweig, Sándor Beniczky
PURPOSE: To elucidate the localization of ictal EEG activity, and correlate it to semiological features in self-limited epilepsy with centrotemporal spikes (formerly called "benign epilepsy with centrotemporal spikes"). METHODS: We have performed ictal electric source imaging, and we analysed electroclinical correlations in three patients with self-limited epilepsy with centrotemporal spikes. RESULTS: The source of the evolving rhythmic ictal activity (9...
September 14, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28919257/seizures-by-the-clock-temporal-patterns-of-psychogenic-nonepileptic-seizures
#16
Udaya Seneviratne, Erica Minato, Eldho Paul
We hypothesized that (1) the occurrence of psychogenic nonepileptic seizures (PNES) is modulated by the interaction between the 24-hour clock and the sleep-wake cycle and (2) the pattern of modulation in PNES differs from epileptic seizures (ES). We sought to test our hypotheses in a cohort of patients diagnosed with PNES or ES in the setting of an epilepsy monitoring unit (EMU). We retrospectively reviewed consecutive video-EEG (VEEG) recordings of patients who underwent monitoring at the EMU of a tertiary hospital...
September 11, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28904515/psychogenic-polydipsia-management-challenges
#17
M S Bhatia, Aparna Goyal, Rashmita Saha, Nimisha Doval
Compulsive water drinking or psychogenic polydipsia is now increasingly seen in psychiatric populations. Effects of increased water intake can lead to hyponatremia causing symptoms of nausea, vomiting, seizures, delirium and can even be life threatening if not recognized and managed early. Here we present a 35-year old adult who was diagnosed with psychogenic polydipsia and was successfully managed with a combination of pharmacotherapy, fluid restriction and psychosocial management.
June 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28895657/identifying-psychogenic-seizures-through-comorbidities-and-medication-history
#18
Wesley T Kerr, Emily A Janio, Chelsea T Braesch, Justine M Le, Jessica M Hori, Akash B Patel, Norma L Gallardo, Janar Bauirjan, Shannon R D'Ambrosio, Andrea M Chau, Eric S Hwang, Emily C Davis, Albert Buchard, David Torres-Barba, Mona Al Banna, Sarah E Barritt, Andrew Y Cho, Jerome Engel, Mark S Cohen, John M Stern
OBJECTIVE: Low-cost evidence-based tools are needed to facilitate the early identification of patients with possible psychogenic nonepileptic seizures (PNES). Prior to accurate diagnosis, patients with PNES do not receive interventions that address the cause of their seizures and therefore incur high medical costs and disability due to an uncontrolled seizure disorder. Both seizures and comorbidities may contribute to this high cost. METHODS: Based on data from 1,365 adult patients with video-electroencephalography-confirmed diagnoses from a single center, we used logistic and Poisson regression to compare the total number of comorbidities, number of medications, and presence of specific comorbidities in five mutually exclusive groups of diagnoses: epileptic seizures (ES) only, PNES only, mixed PNES and ES, physiologic nonepileptic seizurelike events, and inconclusive monitoring...
November 2017: Epilepsia
https://www.readbyqxmd.com/read/28867568/psychogenic-nonepileptic-seizures-in-patients-with-surgically-treated-temporal-lobe-epilepsy-presurgical-and-de-novo-postsurgical-occurrence
#19
Karina A González Otárula, Yee-Leng Tan, François Dubeau, José A Correa, Edward Chang, Jeffery A Hall, Robert C Knowlton, Eliane Kobayashi
Whether occurring before or after an epilepsy surgery, psychogenic nonepileptic seizures (PNES) impact treatment options and quality of life of patients with epilepsy. We investigated the frequency of pre- and postsurgical PNES, and the postsurgical Engel and psychiatric outcomes in patients with drug-resistant temporal lobe epilepsy (TLE). We reviewed 278 patients with mean age at surgery of 37.1±12.4years. Postsurgical follow-up information was available in 220 patients, with average follow-up of 4years...
October 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28865883/semiology-of-psychogenic-nonepileptic-seizures-an-international-cross-cultural-study
#20
Ali A Asadi-Pooya, Kette Valente, Ruda Alessi, Jennifer Tinker
PURPOSE: We compared the semiology of psychogenic nonepileptic seizures (PNES) between patients from the USA and Brazil. This international cross-cultural comparative study may expand understanding of PNES across the borders. METHODS: We retrospectively investigated all patients with PNES admitted to one epilepsy center in the USA and one in Brazil. We classified their seizures into four classes: generalized motor, akinetic, focal motor, and subjective symptoms...
August 30, 2017: Epilepsy & Behavior: E&B
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