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PNES AND Seizures

F Brigo, S Lattanzi
The diagnosis and management of psychogenic nonepileptic seizures (PNES) are among the most challenging tasks that neurologists face in their daily practice. PNES are abrupt, transitory, paroxysmal episodes which resemble an epileptic seizure, but are not caused by epileptiform activity. Thus, they lack the typical ictal electrophysiologic changes that accompany an epileptic seizure, and are commonly believed to have psychogenic process(es) as causative factor(s) [1]. This article is protected by copyright...
October 16, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Bhargavi Ramanujam, Deepa Dash, Manjari Tripathi
PURPOSE: To assess the contribution home-videos made on mobile phones can make to the diagnosis of Psychogenic Nonepileptic Seizures (PNES). METHODS: Consecutive patients 10-50 years old, with episodes of altered behavior or abnormal movements, unresponsiveness, or falls, were recruited after they had obtained 'good' or 'fair' quality (quality of video scale (QOV)) home-videos of their episodes on personal mobile phones; these subjects underwent video-electroencephalography (VEEG)...
October 3, 2018: Seizure: the Journal of the British Epilepsy Association
Iliana Kotwas, Jean-Arthur Micoulaud-Franchi, Stéphanie Khalfa, Aileen McGonigal, Mireille Bastien-Toniazzo, Fabrice Bartolomei
BACKGROUND: Temporal lobe epilepsy (TLE) and psychogenic non-epileptic seizures (PNES) are conditions frequently associated with dysfunction in emotional regulation leading to increased risk of affective disorders. This study investigates emotional processing with an objective measure of emotional reactivity in patients with TLE and patients with PNES. METHODS: 34 patients with TLE and 14 patients with PNES were evaluated on skin conductance responses (SCR) to emotions induced by short films and compared to 34 healthy controls...
October 5, 2018: Journal of Affective Disorders
Sara Gasparini, Ettore Beghi, Edoardo Ferlazzo, Massimiliano Beghi, Vincenzo Belcastro, Klaus P Biermann, Gabriella Bottini, Giuseppe Capovilla, Rosa A Cervellione, Vittoria Cianci, Giangennaro Coppola, Cesare M Cornaggia, Pasquale De Fazio, Salvatore De Masi, Giovambattista De Sarro, Maurizio Elia, Giuseppe Erba, Lucia Fusco, Antonio Gambardella, Valentina Gentile, Anna T Giallonardo, Renzo Guerrini, Francesca Ingravallo, Alfonso Iudice, Angelo Labate, Ersilia Lucenteforte, Adriana Magaudda, Laura Mumoli, Costanza Papagno, Giovanni B Pesce, Eugenio Pucci, Pietrantonio Ricci, Antonino Romeo, Rui Quintas, Chiara Sueri, Giovanna Vitaliti, Riccardo Zoia, Umberto Aguglia
BACKGROUND: The International League Against Epilepsy (ILAE) proposed a diagnostic scheme for psychogenic nonepileptic seizures (PNES). The debate on ethical aspects of the diagnostic procedures is ongoing, the treatment is not standardized, and management might differ according to the age groups. OBJECTIVE: To reach an expert and stakeholder consensus on PNES management. METHODS: A board comprising adult and child neurologists, neuropsychologists, psychiatrists, pharmacologists, experts in forensic medicine and bioethics as well as patients' representatives was formed...
October 9, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Gregg H Rawlings, Ian Brown, Markus Reuber
PURPOSE: This study is based on a narrative analysis of individuals' written accounts of living with epilepsy (n = 29) or psychogenic non-epileptic seizures (n = 20, PNES). Narrative analysis looks at both the content and structure of the personal account. We used a form of narrative analysis that allowed us to identify common story lines, otherwise known as narrative typologies, potentially characteristic of these patient groups. Different narrative typologies were described and compared between writers with the two conditions...
September 28, 2018: Seizure: the Journal of the British Epilepsy Association
David K Chen, Hina Dave, Kareem Gadelmola, Myrtle Jeroudi, Melissa Fadipe
We aim to demonstrate, in a sufficiently powered and standardized study, that the success rate of inducing psychogenic nonepileptic seizures (PNES) without placebo (saline infusion) is noninferior to induction with placebo. The clinical data of 170 consecutive patients with suspected PNES who underwent induction with placebo from January 21, 2009 to March 31, 2013 were pair-matched with 170 consecutive patients with suspected PNES who underwent the same induction technique but without addition of placebo from April 1, 2013 to February 7, 2018 at the same center...
October 1, 2018: Epilepsia
Roberta Vasta, Antonio Cerasa, Alessia Sarica, Emanuele Bartolini, Iolanda Martino, Francesco Mari, Tiziana Metitieri, Aldo Quattrone, Antonio Gambardella, Renzo Guerrini, Angelo Labate
Psychogenic nonepileptic seizures (PNES) are episodes of paroxysmal impairment associated with a range of motor, sensory, and mental manifestations, which perfectly mimic epileptic seizures. Several patterns of neural abnormalities have been described without identifying a definite neurobiological substrate. In this multicenter cross-sectional study, we applied a multivariate classification algorithm on morphological brain imaging metrics to extract reliable biomarkers useful to distinguish patients from controls at an individual level...
September 28, 2018: Epilepsy & Behavior: E&B
Shahram Izadyar, Vishal Shah, Brandon James
BACKGROUND: The available information on postictal semiology and behavior in patients with psychogenic nonepileptic seizure (PNES) is limited. In this study, we explore the differences in postictal semiology and behavior between patients with epileptic seizure (ES) and PNES and focus on clinical features that may be helpful in differentiating these two conditions. METHODS: In this retrospective study, video-electroencephalograph (video-EEG) of 144 seizures from 64 patients with PNES and 66 seizures from 42 patients with ES were reviewed...
September 26, 2018: Epilepsy & Behavior: E&B
Cayla J Duncan, Nicole A Roberts, Kristin A Kirlin, David Parkhurst, Mary H Burleson, Joseph F Drazkowski, Joseph I Sirven, Katherine H Noe, Amy Z Crepeau, Matthew T Hoerth, Dona E C Locke
Psychological assessment measures are frequently used to evaluate patients in epilepsy monitoring units. One goal of that assessment is to contribute information that may help with differential diagnosis between epilepsy and psychogenic nonepileptic seizures (PNES). The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) is one such measure. Del Bene et al. (2017) recently published an analysis that was the first to compare MMPI-2-RF scale elevations between diagnostic groups stratified by sex...
September 24, 2018: Epilepsy & Behavior: E&B
Jerzy P Szaflarski, W Curt LaFrance
No abstract text is available yet for this article.
July 2018: Epilepsy Currents
Marjan Asadollahi, Leila Simani
OBJECTIVE: To assess the value of postictal serum Ubiquitin C-terminal hydrolase (UCHL-1), a neuronal biomarker, and S100-B, a glial biomarker, levels, in differentiate epileptic seizures (ES) form psychogenic attacks. METHODS: In this analytical cross-sectional study, serum UCHL-1 and S100-B levels were measured within six hours of occurring seizure, in 43 patients with ES, 20 patients with psychogenic non-epileptic seizures (PNES) and 19 healthy individuals by electrochemiluminescence immunoassay...
September 22, 2018: Brain Research
Kirsten Labudda, Michael Frauenheim, Dominik Illies, Inga Miller, Mario Schrecke, Nadine Vietmeier, Christian Brandt, Christian G Bien
Several studies found high prevalence rates of psychiatric disorders in patients with pure psychogenic nonepileptic seizures (PNES). Traumatic experiences were also reported to be elevated in patients with PNES and were discussed as a crucial risk factor for the development of PNES. Much less is known about psychiatric comorbidities and specifically, about trauma history in patients with PNES and coexisting epilepsy. Here, we aimed at directly comparing psychiatric disorders and traumatic life experiences in patients with pure PNES and in patients with PNES and coexisting epilepsy...
September 18, 2018: Epilepsy & Behavior: E&B
Alexandra Carter, Alyssa Denton, Lady D Ladino, Islam Hassan, Tyson Sawchuk, Thomas Snyder, Mirna Vrbancic, Markus Reuber, Richard Huntsman, Jose F Tellez-Zenteno
PURPOSE: Psychogenic nonepileptic seizures (PNES) are one of the most common differential diagnoses of epilepsy. Our objective is to describe current medical care in Canada and identify patterns of practice and service gaps. METHODS: In 2015, a 36-question survey was sent via email to the 131 members of the Canadian League Against Epilepsy. The questions were designed after literature review and discussion with the ILAE PNES Task Force. Questions were separated into 5 sections: 1) the role of the respondent and their exposure to PNES, 2) diagnostic methods, 3) management of PNES, 4) etiological factors, and 5) problems accessing health care...
October 2018: Seizure: the Journal of the British Epilepsy Association
Hiroto Iwasa, Reiko Hosaka, Sunao Kaneko
Psychiatric comorbidities, including mood, anxiety, psychotic disorders, and autism spectrum disorder are common in patients with epilepsy (PWE), often occurring at rates 2-3-fold or higher than in the general population without epilepsy. Furthermore, an attention should be paid to psychiatric symptoms together with those caused by antiepileptic drug therapy, epilepsy surgery, and vagus nerve stimulation because these therapies sometimes induce psychiatric comorbidities. It is important to differentiate psychogenic non epileptic seizures (PNES) from epilepsy, and to provide patients with psychiatric treatment...
September 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Brad T Tyson, Shannon Baker, Matthew Greenacre, Katrina J Kent, Jonathan D Lichtenstein, Alana Sabelli, Laszlo A Erdodi
OBJECTIVE: Differentiating epileptic seizures (ES) from psychogenic nonepileptic seizures (PNES) represents a challenging differential diagnosis with important treatment implications. This study was designed to explore the utility of neuropsychological test scores in differentiating ES from PNES. METHOD: Psychometric data from 72 patients with ES and 33 patients with PNES were compared on various tests of cognitive ability and performance validity. Individual measures that best discriminated the diagnoses were then entered as predictors in a logistic regression equation with group membership (ES vs...
August 29, 2018: Epilepsy & Behavior: E&B
Alistair Wardrope, Ellen Newberry, Markus Reuber
BACKGROUND: Transient loss of consciousness (TLOC) is a common presentation in primary care. Over 90% of these are due to epileptic seizures (ES), syncope, or psychogenic non-epileptic seizures (PNES). Misdiagnosis rates are as high as 30%. METHODS: Systematic review of inter-ictal clinical criteria to aid differential diagnosis of TLOC. We searched Medline, EMBASE, CINAHL and PsycInfo databases, as well as relevant grey literature depositories and citations of relevant reviews and guidelines for studies giving sensitivity and specificity of inter-ictal clinical characteristics used to differentiate between causes of TLOC...
October 2018: Seizure: the Journal of the British Epilepsy Association
Graeme David Hammond-Tooke, Felipe Tallabs Grajeda, Helen Macrorie, Elizabeth A Franz
Abnormal response inhibition has been demonstrated in psychogenic movement disorders (PMD) and is a plausible mechanism for other forms of functional neurological symptom disorder (FNSD), in which response inhibition has not yet been investigated. Response inhibition was therefore studied in patients with FNSD, including patients with psychogenic non-epileptic seizures (PNES), functional weakness (FW) or both. Twenty-nine patients with FNSD and 29 age and sex-matched healthy volunteers underwent a go-nogo task, a stop-signal reaction time (SSRT) task, and a negative priming flanker task...
August 22, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Martin Salinsky, Paul Rutecki, Karen Parko, Elizabeth Goy, Daniel Storzbach, Maya O'Neil, Laurence Binder, Sandra Joos
OBJECTIVE: To determine the frequency and severity of psychiatric disorders and attribution of seizures to traumatic brain injury (TBI) in veterans with verified psychogenic nonepileptic seizures (PNES) versus epileptic seizures (ES). METHODS: We studied 333 consecutive admissions to the monitoring units of three Veterans Administration epilepsy centers. All patients underwent continuous video-electroencephalographic recording to define definite PNES or ES. Evaluations included the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, PTSD Checklist, Beck Depression Inventory II, and Patient Seizure Etiology Questionnaire...
August 24, 2018: Epilepsia
Shmuel Appel, Anna Gelfand, Galina Kotlyar, Ron Milo
PURPOSE: A period of military conflict is characterized by high level of stress. In this study, we examined the seizure frequency in a civilian population of patients with seizures during a period of military conflict. METHODS: This retrospective study investigated seizure frequency in patients with seizures seen at the epilepsy clinic of Barzilai Medical Center during the summer of 2014 when the military operation "Protective Edge" between Israel and Gaza took place...
October 2018: Seizure: the Journal of the British Epilepsy Association
Leila Simani, Mahboubeh Elmi, Marjan Asadollahi
PURPOSE: There has been increasing interest in the use of different biomarkers to help distinguish psychogenic from epileptic seizures, in patients presenting acutely with seizure-like events. In the present study, we measured serum glial fibrillary astrocytic protein (GFAP) levels in patients presenting with such events who were subsequently diagnosed as epileptic seizures (ESs) or psychogenic non-epileptic seizures (PNESs) and compared GFAP levels obtained with those found in healthy subjects...
October 2018: Seizure: the Journal of the British Epilepsy Association
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