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Psychogenic Seizures

Xin Tong, Dongmei An, Markus Reuber, Qin Zhang, Dong Zhou
PURPOSE: This study is intended to provide an overview of diagnostic and treatment services for patients with psychogenic nonepileptic seizures (PNES) across China. METHODS: Using a questionnaire devised by the PNES Task Force of Neuropsychiatry Commission of the International League Against Epilepsy (ILAE), we conducted a survey among Chinese health professionals at the Sixth Advanced International Course: Clinical Epileptology. Descriptive analyses were performed...
January 31, 2018: Seizure: the Journal of the British Epilepsy Association
Sayra Catalina Coral Castro, Gislaine Verginia Baroni, William Alves Martins, André Luis Fernandes Palmini, Luísa Weber Bisol
OBJECTIVES: The objective of the study was to access the suicide risk (SR) in patients with refractory epilepsy and its association with temperament and sleep quality. METHODS: A total of 50 consecutive patients referred for epilepsy surgery evaluation in the Porto Alegre Epilepsy Surgery Program were included. All patients had a detailed neurologic and psychiatric evaluation, including video-electroencephalogram (VEEG), high-resolution magnetic ressonance imaging (MRI), and neuropsychologic assessment...
February 8, 2018: Epilepsy & Behavior: E&B
Wesley T Kerr, Emily A Janio, Chelsea T Braesch, Justine M Le, Jessica M Hori, Akash B Patel, Norma L Gallardo, Janar Bauirjan, Andrea M Chau, Eric S Hwang, Emily C Davis, Albert Buchard, David Torres-Barba, Shannon D'Ambrosio, Mona Al Banna, Andrew Y Cho, Jerome Engel, Mark S Cohen, John M Stern
OBJECTIVE: Psychogenic nonepileptic seizure (PNES) is a common diagnosis after evaluation of medication resistant or atypical seizures with video-electroencephalographic monitoring (VEM), but usually follows a long delay after the development of seizures, during which patients are treated for epilepsy. Therefore, more readily available diagnostic tools are needed for earlier identification of patients at risk for PNES. A tool based on patient-reported psychosocial history would be especially beneficial because it could be implemented in the outpatient clinic...
February 1, 2018: Epilepsy & Behavior: E&B
Johannes D Lang, David C Taylor, Burkhard S Kasper
In epilepsy, individual seizures can be triggered by a variety of external and internal stimuli. One of the most common trigger factors reported by patients is stress. However prevalent, stress-related triggering of episodes seems underappreciated in epilepsy for various reasons, and its misinterpretation often leads to other diagnoses, e.g., psychogenic nonepileptic seizures (PNES) or normal reactions. This article illustrates the significant role of stress as a seizure-provoking factor by referring to nine patient narratives...
February 1, 2018: Epilepsy & Behavior: E&B
Kirsten Labudda, Dominik Illies, Christian G Bien, Frank Neuner
PURPOSE: The interictal dysphoric disorder (IDD) is a proposed epilepsy-specific psychiatric condition characterized by a conglomerate of symptoms such as depression, irritability, euphoria, and anxiety. However, there are doubts about IDD as an independent entity and about its presumed epilepsy-specific nature. METHODS: Here, we investigated the association between psychiatric disorders and IDD in 120 patients with epilepsy, also analyzing potential associations between IDD symptoms and epilepsy-related variables...
January 29, 2018: Epilepsy Research
Rosalind Kandler, Sarah Lawrence, Catherine Pang, Ming Lai, Kimberley Whitehead
PURPOSE: To produce an evidence base to formulate guidelines for optimal performance of EEG in patients referred with a possible diagnosis of non-epileptic attack disorder (NEAD). METHODS: 51 UK EEG departments participated in the prospective study. A pro-forma was completed for all consecutive patients aged 5 years and over referred for EEG over a six month period. Information obtained included referral diagnosis, occurrence/type of attack during EEG, the use of suggestion, length of recording and who was present during the EEG...
January 10, 2018: Seizure: the Journal of the British Epilepsy Association
Zahari N Tchopev, Ping-Hong Yeh, Greg W Morgan, Eric Meyer, Johanna M Wolf, John M Ollinger, Gerard P Riedy, Lisa C Young
Sleep-related hypermotor epilepsy (SHE) (previously frontal lobe epilepsy) is a rare seizure disorder commonly misdiagnosed or unrecognized, causing negative patient sequelae. While usually reported in familial studies, it is more commonly acquired. Diagnosis is a challenge due to its low incidence in comparison with the more common sleep disorders or psychogenic etiologies in the differential diagnosis. Diagnosis is scaled on degree of certainty based on described or clinically documented semiology, with video EEG as a helpful, but not necessary, adjunct...
2018: Frontiers in Neurology
Angelo Labate, Laura Mumoli, Antonio Curcio, Giovanni Tripepi, Graziella D'Arrigo, Edoardo Ferlazzo, Umberto Aguglia, Ciro Indolfi, Aldo Quattrone, Antonio Gambardella
BACKGROUND AND PURPOSE: Misdiagnosis of refractory epilepsy (rE) is common and such patients experience a long diagnostic delay. Our aim was to identify key clinical/laboratory factors in order to obtain an alternative diagnosis in patients referred for rE. METHODS: Between January 2010 and December 2015, 125 consecutive patients with a diagnosis of rE were prospectively enrolled. All patients underwent a comprehensive neurological, neuropsychiatric and cardiologic evaluation, and had an observation time of at least one year after the study entry...
January 22, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
David G Benditt, Wayne O Adkisson, Richard Sutton, Robin K Mears, Scott Sakaguchi
INTRODUCTION: Diagnostic ambulatory ECG (AECG) monitoring is widely used for evaluating syncope and collapse, and practice guidelines provide recommendations regarding optimal AECG device selection. However, whether physicians utilize AECGs in accordance with the pertinent guidelines is unclear. This study assessed utilization of AECG monitoring systems for syncope and collapse diagnosis by physicians in the United States. METHODS AND RESULTS: A quantitative survey was undertaken of physicians comprising multiple specialties (Emergency Room, n = 35; Primary care, n = 35; Hospitalists, n = 30; Neurologists, n = 30; non-implanting, n = 34 and implanting-Cardiologists, n = 35)...
January 4, 2018: Pacing and Clinical Electrophysiology: PACE
Jerzy P Szaflarski, Jane B Allendorfer, Rodolphe Nenert, W Curt LaFrance, Helen I Barkan, Jennifer DeWolfe, Sandipan Pati, Ashley E Thomas, Lawrence Ver Hoef
Studies of emotion processing are needed to better understand the pathophysiology of psychogenic nonepileptic seizures (PNES). We examined the differences in facial emotion processing between 12 patients with PNES, 12 patients with temporal lobe epilepsy (TLE), and 24 matched healthy controls (HCs) using fMRI with emotional faces task (EFT) (happy/sad/fearful/neutral) and resting state connectivity. Compared with TLE, patients with PNES exhibited increased fMRI response to happy, neutral, and fearful faces in visual, temporal, and/or parietal regions and decreased fMRI response to sad faces in the putamen bilaterally...
February 2018: Epilepsy & Behavior: E&B
Ángela Milán-Tomás, Michelle Persyko, Martin Del Campo, Colin M Shapiro, Karl Farcnik
The purpose of this review is to provide an update of the research regarding the etiology, diagnosis and management of psychogenic non-epileptic seizures (PNES). A literature search using Pubmed, Ovid MEDLINE and EMBASE database was performed from 2000 up to August 2017. We have evaluated the different factors leading to PNES as well as the diagnostic approach and management of this disorder which continue to be very difficult. The coexistence of epilepsy and PNES poses special challenges and requires the coordinated efforts of the family physicians, psychiatrists, psychologists and neurologists...
January 8, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Kousuke Kanemoto
It is highly recommended not to base the diagnosis of psychogenic non-epileptic seizures (PNES) on one single sign. Yet, the combination of several symptoms may be highly indicative of PNES. The aim of this paper is to demonstrate that some combinations of symptoms are more easily recorded and that some are more indicative of PNES. We review and analize various symptom combinations including convulsions, falling, and impaired consciousness. Further, we examine and discuss all individual symptoms that are known to be associated with PNES...
December 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
Yuichi Tashiro, Hiroshi Takashima
Autoimmune encephalopathies are clinically and immunologically heterogeneous disorders. At least 20 types of autoimmune encephalopathies have been discovered, with the most common type being Hashimoto encephalopathy. In clinical situations, we often observe that patients with autoimmune encephalopathy are misdiagnosed because they exhibit signs similar to those observed in functional psychogenic movement, conversion, or somatoform disorders. We clinically examined over 100 patients with autoimmune encephalopathy...
December 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
Gholam K Motamedi
No abstract text is available yet for this article.
November 24, 2017: Epilepsy & Behavior: E&B
Joashlie M Méndez-Ruiz, Alfonso Martínez-Taboas, Yeira M Valdez-Pimentel, Miguel Torres-Narváez, Marianette Colón-Laboy, Gisela G Jiménez-Colón, José Rodríguez-Gómez, Christian J González-Jiménez
OBJECTIVE: Specialized epilepsy clinics receive many cases (20%-30% of total cases) in which the patients are diagnosed with psychogenic non-epileptic seizures (PNES). In Puerto Rico, there has been a lack of research on and data about patients with PNES. This study examined the clinical profile of 34 patients with a confirmed diagnosis of PNES. METHODS: A secondary analysis of 34 clinical records of patients with PNES was conducted. The resulting profile was based on clinical interviews, the behavioral presentation of seizures, the history of traumatic experiences or abuse, and the relationship between PNES events and life stressors...
December 2017: Puerto Rico Health Sciences Journal
Benjamin Tolchin, Barbara A Dworetzky, Gaston Baslet
We conducted a prospective cohort study, examining long-term adherence with psychiatric treatment among patients with psychogenic nonepileptic seizures (PNES). Subjects diagnosed with documented PNES were scheduled for 4 psychiatric visits. Survival analysis was performed, and covariates were assessed for association with time to nonadherence using Cox proportional hazard regression analysis. One hundred twenty-three subjects were recruited and followed for up to 17 months. Eighty percent of subjects attended the first outpatient visit, 42% attended the second, 24% attended the third, and only 14% remained adherent through the fourth visit...
January 2018: Epilepsia
Mahendra Javali, Purushottam Acharya, Shripal Shah, Rohan Mahale, Pushparaja Shetty, Srinivasa Rangasetty
Introduction: Review of literature revealed very limited studies considering a combination of serum prolactin (PRL) and serum creatine kinase (CK) as markers for differentiating epileptic and psychogenic nonepileptic seizures (PNES). Therefore, in the present study, we analyzed the role of serum PRL and serum CK, individually and in combination. Methodology: This prospective study was conducted in a tertiary care medical teaching hospital over a period of 18 months...
October 2017: Journal of Neurosciences in Rural Practice
Lorna Myers, Robert Trobliger, Kirsty Bortnik, Marcelo Lancman
OBJECTIVE: The objective of the study was to determine whether male and female populations of patients with psychogenic nonepileptic seizures (PNES) differ, in terms of demographic, social/clinical, and etiological factors as well as psychological measures. BACKGROUND: Psychogenic nonepileptic seizures are overrepresented by females; therefore, information about PNES in males is limited. Only a handful of studies have examined PNES and gender, and of those, one was a literature review and with the exception of two, most have had small sample sizes...
January 2018: Epilepsy & Behavior: E&B
Catherine R Garcia, Gulam Q Khan, Amy M Morrow, Priyanka Yadav, Donita D Lightner, Frank G Gilliam, John L Villano
OBJECTIVE: The association of psychogenic non-epileptic seizures (PNES) with primary or secondary brain tumors has not been well described in the literature. We aim to discuss their association, and their impact in brain tumor treatment. PATIENTS AND METHODS: We identified four patients retrospectively from our practice. The diagnosis of PNES was based on clinical suspicion and standard EEG, supplemented with video-EEG recording in 2 patients. RESULTS: The initial diagnosis of brain tumor was associated with a new onset seizure prior to diagnosis...
January 2018: Clinical Neurology and Neurosurgery
Julia L Doss, Sigita Plioplys
Psychogenic nonepileptic seizures is a complicated biopsychosocial disorder with significant morbidity and high cost in children's social, emotional, family, and academic functioning as well as health care service utilization. Misdiagnosis and diagnostic delay, resulting from both lack of access to approved standards for diagnosing and service providers comfortable with diagnosing and treating this disorder, impact prognosis. Treatment in close proximity to symptom onset is thought to provide the best chance for remission...
January 2018: Child and Adolescent Psychiatric Clinics of North America
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