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https://www.readbyqxmd.com/read/28927714/differentiating-pnes-from-epileptic-seizures-using-conversational-analysis
#1
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/28922194/benign-neonatal-sleep-myoclonus-evokes-somatosensory-responses
#2
Emma Losito, Monika Eisermann, Patricia Vignolo, Shushanik Hovhannisyan, Jean François Magny, Anna Kaminska
PURPOSE: Benign neonatal sleep myoclonus is a common nonepileptic condition occurring in neurologically normal full-term newborns. During jerks, EEG has always been described as normal. The aim of this study was to describe EEG changes associated with the myoclonic jerks. METHODS: Polygraphic video-EEG recordings of four full-term neonates presenting benign neonatal sleep myoclonus were studied. Myoclonic jerks were analyzed regarding their topography, frequency, propagation pattern, and reflex component...
September 14, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28919257/seizures-by-the-clock-temporal-patterns-of-psychogenic-nonepileptic-seizures
#3
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/28913875/alterations-in-the-%C3%AE-2-%C3%AE-ligand-thrombospondin-1-in-a-rat-model-of-spontaneous-absence-epilepsy-and-in-patients-with-idiopathic-genetic-generalized-epilepsies
#4
Ines Santolini, Roberta Celli, Milena Cannella, Tiziana Imbriglio, Michela Guiducci, Pasquale Parisi, Julian Schubert, Michele Iacomino, Federico Zara, Holger Lerche, Slavianka Moyanova, Richard Teke Ngomba, Gilles van Luijtelaar, Giuseppe Battaglia, Valeria Bruno, Pasquale Striano, Ferdinando Nicoletti
OBJECTIVES: Thrombospondins, which are known to interact with the α2 δ subunit of voltage-sensitive calcium channels to stimulate the formation of excitatory synapses, have recently been implicated in the process of epileptogenesis. No studies have been so far performed on thrombospondins in models of absence epilepsy. We examined whether expression of the gene encoding for thrombospondin-1 was altered in the brain of WAG/Rij rats, which model absence epilepsy in humans. In addition, we examined the frequency of genetic variants of THBS1 in a large cohort of children affected by idiopathic/genetic generalized epilepsies (IGE/GGEs)...
September 15, 2017: Epilepsia
https://www.readbyqxmd.com/read/28895657/identifying-psychogenic-seizures-through-comorbidities-and-medication-history
#5
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...
September 12, 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
#6
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...
August 31, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28865883/semiology-of-psychogenic-nonepileptic-seizures-an-international-cross-cultural-study
#7
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
https://www.readbyqxmd.com/read/28865250/delay-in-diagnosis-of-psychogenic-nonepileptic-seizures-in-adults-a-post-hoc-study
#8
Ali A Asadi-Pooya, Jennifer Tinker
PURPOSE: The aim of the current post hoc study was to investigate factors associated with delay in diagnosis of adult patients with psychogenic nonepileptic seizures (PNES). METHODS: We retrospectively investigated all patients with PNES admitted to the epilepsy-monitoring unit at the Jefferson Comprehensive Epilepsy Center from 2012 through 2016. We identified the median time to diagnosis of PNES and divided the patients into two groups. We studied factors associated with delay in diagnosis of PNES...
August 30, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28852255/temporal-lobe-seizures-presenting-as-abrupt-clinging-behavior-in-a-child
#9
Shabina A Sheth, Nilanjan C Chandra, Ritambhara Y Mehta
True and psychogenic nonepileptic seizures (PNES) go hand in hand. One colors the picture of other. Although it is thought that children carry lower risk for PNES than adults, this may represent the under-diagnosis of this condition in childhood due to few studies on this specific topic. Again, true seizure can be misdiagnosed by dramatic and varied manifestations appearing as psychological phenomena. We report a case of a 9-year-old boy presenting with sudden onset, short lasting, off and on different "melodramatic" episodic behavioral problems with La-Belle' indifference without loss of consciousness, appearing to be of psychogenic origin but finally ended with a diagnosis of temporal lobe epilepsy and responded dramatically with antiepileptics...
July 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28811059/an-infant-with-epilepsy-and-recurrent-hemiplegia-due-to-compound-heterozygous-variants-in-atp1a2
#10
Colin Wilbur, Sarah E Buerki, Ilaria Guella, Eric B Toyota, Daniel M Evans, Marna B McKenzie, Anita Datta, Aspasia Michoulas, Shelin Adam, Margot I Van Allen, Tanya N Nelson, Matthew J Farrer, Mary B Connolly, Michelle Demos
BACKGROUND: Pathogenic heterozygous variants in the ATP1A2 gene have most commonly been associated with familial hemiplegic migraine. However, a wide spectrum of phenotypes that include alternating hemiplegia of childhood and epilepsy have been described. PATIENT DESCRIPTION: We describe a boy who presented at age three months with a complex phenotype that included epilepsy, nonepileptic paroxysmal events, and recurrent hemiplegia. Magnetic resonance imaging demonstrated unilateral cortical edema during a severe episode of hemiplegia that was followed by a persistent mild hemiparesis...
June 8, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28806632/clinical-utility-of-serum-lactate-levels-for-differential-diagnosis-of-generalized-tonic-clonic-seizures-from-psychogenic-nonepileptic-seizures-and-syncope
#11
Ebru Apaydın Doğan, Ali Ünal, Aslıhan Ünal, Çağla Erdoğan
BACKGROUND: The differential diagnosis of generalized tonic-clonic seizures (GTCS), psychogenic nonepileptic seizures (PNES), and syncope constitutes a major challenge. Misdiagnosis rates up to 20 to 30% are reported in the literature. PURPOSE: To assess the clinical utility of serum lactate levels for differentiation of GTCS, PNES, and syncope based on gender differences. METHODS: Data from 270 patients were evaluated retrospectively. Only patients ≥18 years old with the final diagnosis of GTCS, PNES, or syncope in their chart were recruited...
August 11, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28771044/retrospective-analysis-of-nonepileptic-patients-with-isolated-epileptiform-discharges-treated-with-anticonvulsants
#12
Ronald J Swatzyna, Jay D Tarnow, Meyer L Proler, Alexandra J Roark, Erin K MacInerney, Gerald P Kozlowski
Many antiepileptic drugs (AEDs) have been tested on nonepileptic patients with a variety of diagnoses. The Food and Drug Administration has only approved certain AEDs for a small number of psychiatric conditions. There are few studies of nonepileptic patients that recommend an empirical trial of AEDs when isolated epileptiform discharges (IEDs) are identified in the electroencephalogram (EEG). However, no trials have been published. The purpose of this study is to evaluate the outcome of treating nonepileptic patients with AEDs when IEDs are present...
September 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28766469/the-forsaking-of-the-clinical-eeg-by-psychiatry-how-justified
#13
Nash N Boutros
Despite decades of publications attesting to the role of the clinical EEG in diagnosing and managing psychiatric disorders, the procedure remains highly underutilized in the practice of psychiatry. The visually inspected EEG (vEEG) can detect various forms of abnormalities, each with its own clinical significance. Abnormalities can be paroxysmal (i.e., suggestive of an epileptic-like process) or stationary. The most important unanswered question remains the value of detecting epileptiform activity in a nonepileptic psychiatric patient in predicting favorable responses to anticonvulsant treatment...
August 2, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28755568/what-patients-think-about-psychogenic-nonepileptic-seizures-in-buenos-aires-argentina-a-qualitative-approach
#14
Mercedes Sarudiansky, Alejandra Inés Lanzillotti, María Marta Areco Pico, Cristina Tenreyro, Laura Scévola, Silvia Kochen, Luciana D'Alessio, Guido Pablo Korman
PURPOSE: To analyse the methods of reasoning with regard to patients' experiences of living with psychogenic nonepileptic seizures (PNES) in Buenos Aires, Argentina. METHOD: A qualitative approach using semi-structured interviews was used to gain an in-depth and contextual understanding of the perspectives of five patients with PNES. Data collection and analysis were followed by an inductive and interpretive approach informed by the principles of thematic analysis...
July 20, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28734750/deconstructing-stigma-in-psychogenic-nonepileptic-seizures-an-exploratory-study
#15
Gregg H Rawlings, Ian Brown, Markus Reuber
Psychogenic nonepileptic seizures (PNES) are classified as a mental disorder, the manifestations of which superficially resemble epileptic seizures. There is a notable lack of in-depth qualitative or quantitative studies investigating the stigma attached to PNES. The current study is an exploratory analysis into the nature of perceived stigma in those with PNES when compared with individuals with epilepsy. Individuals with epilepsy (n=78) and PNES (n=47) were recruited from a United Kingdom hospital or membership-led organizations for individuals living with seizures...
July 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28728045/postdiagnosis-neurological-care-for-patients-with-psychogenic-nonepileptic-spells-pnes
#16
Chloe E Hill, Hannah Schwartz, Nabila Dahodwala, Brian Litt, Kathryn A Davis
OBJECTIVE: This study investigated continuity of neurological care for patients discharged from the epilepsy monitoring unit (EMU) with a diagnosis of psychogenic nonepileptic spells (PNES). Because PNES are seizure-like episodes that cannot be explained by abnormal electrical brain activity, they are challenging for patients to understand and accept. Consequently, after diagnosis, patients commonly fail to start recommended psychotherapy and instead pursue redundant medical care. As consistent relationships with healthcare providers may help, we instituted standard follow-up for patients diagnosed with PNES...
September 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28695610/anion-gap-can-differentiate-between-psychogenic-and-epileptic-seizures-in-the-emergency-setting
#17
Yi Li, Liesl Matzka, Louise Maranda, Daniel Weber
Differentiation between psychogenic nonepileptic seizures (PNES) and generalized convulsive epileptic seizures (ES) is important for appropriate triaging in the emergency department (ED). This can be difficult in the ED, as the event is often not witnessed by a medical professional. In the current study, we investigated whether anion gap (AG), bicarbonate, and the Denver Seizure Score (DSS) could differentiate between PNES and ES. Of a total of 1,354 subjects reviewed from a tertiary care medical center, 27 PNES and 27 ES patients were identified based on clinical description and subsequent electroencephalogram...
September 2017: Epilepsia
https://www.readbyqxmd.com/read/28688166/triheptanoin-for-the-treatment-of-brain-energy-deficit-a-14-year-experience
#18
REVIEW
Fanny Mochel
Triheptanoin is an odd-chain triglyceride with anaplerotic properties-that is, replenishing the pool of metabolic intermediates in the Krebs cycle. Unlike even-chain fatty acids metabolized to acetyl-CoA only, triheptanoin can indeed provide both acetyl-CoA and propionyl-CoA, two key carbon sources for the Krebs cycle. Triheptanoin was initially used in patients with long-chain fatty acid oxidation disorders. The first demonstration of the possible benefit of triheptanoin for brain energy deficit came from a patient with pyruvate carboxylase deficiency, a severe metabolic disease that affects anaplerosis in the brain...
July 8, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28684944/treatment-challenges-in-nonepileptic-psychogenic-seizures-finding-the-perfect-fit-for-the-no-one-size-fits-all-group
#19
COMMENT
Roy Martin
No abstract text is available yet for this article.
May 2017: Epilepsy Currents
https://www.readbyqxmd.com/read/28664038/case-report-epilepsy-surgical-outcome-for-epileptic-and-non-epileptic-seizures-with-posttraumatic-stress-disorder-and-depression
#20
Mazen Basheikh
A 48-year-old male was diagnosed with both drug resistant epilepsy and psychogenic nonepileptic seizures. Both diagnoses were confirmed by video-EEG monitoring. His epileptic seizures were a consequence of right mesial temporal sclerosis. He was diagnosed by a psychiatrist to have depression and posttraumatic stress disorder (PTSD). Following a right anterior temporal resection he became seizure free (both epileptic and nonepileptic) with a remarkable improvement in his psychiatric comorbidities leading to significant reduction in his psychotropic medications...
2017: Epilepsy & Behavior Case Reports
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