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Ted Lee, Brandon J Warrick, Preeyaporn Sarangarm, Robert L Alunday, Silas Bussmann, Susan C Smolinske, Steven A Seifert
BACKGROUND/OBJECTIVES: The use of levetiracetam (LEV) in the management of drug-induced seizures has not been systematically investigated. Repetitive and continuous seizures that do not respond to benzodiazepines require second line therapy. Levetiracetam has a unique receptor binding site, rapid absorption, no known cardiac effects at therapeutic doses, and is theoretically a good candidate for use in drug-induced seizures. We evaluate the safety of LEV and its association with seizure cessation in this retrospective chart review of patients who received LEV as a control agent in drug-induced seizures...
March 2018: Clinical Toxicology
Vijendra Nath Jha, Pramod Kumar Singh
Dissociative convulsions or pseudoseizures are a difficult to treat common psychiatric condition. In a subset of these patients, the chief complaint is clenching of teeth with apparent nonresponsiveness alone. Neither drugs nor psychotherapeutic interventions have been found to be of much help in its management. Report of two such subsets of cases is presented, in which patients with dissociative convulsions showed sudden, dramatic, and sustained good response to the addition of a muscle relaxant eperisone.
January 2017: Indian Journal of Pharmacology
Lorna Myers, Jace Jones, Nadine Boesten, Marcelo Lancman
PURPOSE: The nature of the symptoms associated with PNES require a multidisciplinary health team. There are too few professionals with an adequate understanding of PNES and therefore many are not able to provide patients with necessary information. In the age of the internet, it is not surprising that patients or caregivers might look for answers online. The purpose of this project was to investigate the online representation of PNES and search frequency for PNES and its associated terms...
August 2016: Seizure: the Journal of the British Epilepsy Association
Juan A Ramos, Sorin J Brull
INTRODUCTION: Psychogenic non-epileptic seizures (PNES or "pseudoseizures") remain an obscure topic in the peri-operative setting. They are sudden and time-limited motor and cognitive disturbances, which mimic epileptic seizures, but are psychogenically mediated. Pseudoseizures occur more frequently than epilepsy in the peri-operative setting. Early diagnosis and management may prevent iatrogenic injury. CASE: 48 year-old female with a history of depression and "seizures" presented for gynecologic surgery...
July 2016: Brazilian Journal of Anesthesiology
Francesca Falzon Aquilina, Daniel Vella Fondacaro
Conversion disorder refers to a set of symptoms where no relevant organic cause is found. These include sensory/motor disturbances, and other neurological symptoms, such as pseudoseizures. Patients with this condition may, by having it, achieve a primary or secondary gain. The condition should be diagnosed when all the relevant investigations are inconclusive. In this case, we use the bio-psycho-social model for the interpretation and guidance of treatment. We also demonstrate how a holistic approach is beneficial when it comes to a multi-dimensional interpretation of such a case...
March 2016: PsyCh Journal
Mark Quigg, Sean Gharai, Jeff Ruland, Catherine Schroeder, Matthew Hodges, Karen S Ingersoll, Frances P Thorndike, Guofen Yan, Lee M Ritterband
PURPOSE: To evaluate how insomnia is associated with seizure control and quality of life in patients with epilepsy. METHODS: Consecutive patients with epilepsy attending clinical visits were surveyed with the Insomnia Severity Index (ISI). Patients had to be treated with at least one anticonvulsant and could not have had documented psychogenic pseudoseizure. The presence or absence of seizures and quality of life (QOLIE-P-10) within the past 4 weeks was recorded...
May 2016: Epilepsy Research
Anand K Sarma, Nabil Khandker, Lisa Kurczewski, Gretchen M Brophy
Epilepsy is one of the most common neurologic illnesses. This condition afflicts 2.9 million adults and children in the US, leading to an economic impact amounting to $15.5 billion. Despite the significant burden epilepsy places on the population, it is not very well understood. As this understanding continues to evolve, it is important for clinicians to stay up to date with the latest advances to provide the best care for patients. In the last 20 years, the US Food and Drug Administration has approved 15 new antiepileptic drugs (AEDs), with many more currently in development...
2016: Neuropsychiatric Disease and Treatment
Paula Andrea Duque, Rafael Vásquez, Miguel Cote
BACKGROUND: Conversion disorder is diagnosed late, by exclusion and with a high risk of complications. There is a wide experience in adults that is not extrapolated to paediatric patients. According to the literature, the prognosis is better in children, but this changes when other variables such are included, such as comorbidities, late diagnosis and a very convincing social image of the neurological disease. OBJECTIVE: To review the medical literature on the clinical features, diagnosis, comorbidities and treatment of this disorder...
October 2015: Revista Colombiana de Psiquiatría
Priyank Patel, Nirav Amin, Shreya B Patel, Catrin Morgan
In July 2014, a 66 year-old lady presented to emergency department after having not been seen for 3 days. She was eventually found in bed not responding verbally. The ambulance service reported tonic-clonic seizures lasting 10-30 s every 3 min. The patient was treated for her seizures with phenytoin and additional benzodiazepines as required. Her seizure had temporarily resolved and she was admitted for investigations. She had no history of epilepsy or seizures. The history of alcoholism and lack of any substantial history of epilepsy, left the team considering whether this was an alcohol induced event or a pseudoseizure...
September 2015: Annals of Medicine and Surgery
Agnieszka Koźmin-Burzyńska, Agnieszka Bratek, Karolina Zawada, Krzysztof Krysta, Irena Krupka-Matuszczyk
BACKGROUND: Conversion (dissociative) disorder is a psychiatric disorder in which somatic symptoms or deficits are present in the absence of a definable organic cause. The etiology of this disorder is not yet fully understood. The most characteristic presentations are: pseudosensory syndromes, pseudoseizures, psychogenic movement disorders and pseudoparalysis. Psychogenic speech disorder is a rare form of conversion (dissociative) disorder. The aim of present case study is to complete the knowledge on this subject...
September 2015: Psychiatria Danubina
Lindsey A Morgan, Jeffrey Buchhalter
BACKGROUND: Paroxysmal nonepileptic events are common in children. Events with a psychological basis, historically referred to as pseudoseizures, are a large subset of paroxysmal nonepileptic events. METHODS: A review of the relevant pediatric and adult literature was performed. RESULTS: It was found that these events have many semioloigc features similar to epileptic events and can be challenging to correctly identify. The use of a detailed history in combination with video encephalography and knowledge of psychogenic paroxysmal nonepileptic events will facilitate making the correct diagnosis...
July 2015: Pediatric Neurology
Sandra Sirrs, Clara D M van Karnebeek, Xiaoxue Peng, Casper Shyr, Maja Tarailo-Graovac, Rupasri Mandal, Daniel Testa, Devin Dubin, Gregory Carbonetti, Steven E Glynn, Bryan Sayson, Wendy P Robinson, Beomsoo Han, David Wishart, Colin J Ross, Wyeth W Wasserman, Trevor A Hurwitz, Graham Sinclair, Martin Kaczocha
BACKGROUND: Fatty acid amide hydrolase 2 (FAAH2) is a hydrolase that mediates the degradation of endocannabinoids in man. Alterations in the endocannabinoid system are associated with a wide variety of neurologic and psychiatric conditions, but the phenotype and biochemical characterization of patients with genetic defects of FAAH2 activity have not previously been described. We report a male with autistic features with an onset before the age of 2 years who subsequently developed additional features including anxiety, pseudoseizures, ataxia, supranuclear gaze palsy, and isolated learning disabilities but was otherwise cognitively intact as an adult...
2015: Orphanet Journal of Rare Diseases
Harsh Garekar, Vishal Dhiman
We report a case of induction of pseudoseizures by anticonvulsant toxicity in a patient with underlying seizure disorder, hence supporting the argument of an organic subtype of pseudoseizure.
July 2015: General Hospital Psychiatry
Francesco Brigo, Stanley C Igwe, Harald Ausserer, Raffaele Nardone, Frediano Tezzon, Luigi Giuseppe Bongiovanni, Michele Tinazzi, Eugen Trinka
Several different terms have been used to describe "psychogenic nonepileptic seizures" (PNES) in the literature. In this study, we evaluated the most common English terms used to describe PNES on Google and in PubMed using multiple search terms ( and The information prevalence of the five terms most frequently used to refer to PNES in PubMed were: psychogenic non(-)epileptic seizure(s), followed by pseudo(-)seizure(s), non(-)epileptic seizure(s), psychogenic seizure(s), and non(-)epileptic event(s)...
March 2015: Epilepsia
Diana Mungall Robinson, Batool F Kirmani
The objective of our study was to emphasize the importance of intensive video EEG monitoring in patients with a well-established diagnosis of epilepsy with moderate cognitive impairment. The idea was to diagnose new onset frequent atypical events prompting the need for frequent emergency room and clinic visits and hospital admissions. Retrospective chart reviews were conducted on patients with chronic epilepsy with moderate cognitive impairment who had an increased incidence of new onset episodes different from the baseline seizures...
2014: Case Reports in Psychiatry
Juan A Ramos, Sorin J Brull
INTRODUCTION: Psychogenic non-epileptic seizures (PNES or "pseudoseizures") remain an obscure topic in the peri-operative setting. They are sudden and time-limited motor and cognitive disturbances, which mimic epileptic seizures, but are psychogenically mediated. Pseudoseizures occur more frequently than epilepsy in the peri-operative setting. Early diagnosis and management may prevent iatrogenic injury. CASE: 48 year-old female with a history of depression and "seizures" presented for gynecologic surgery...
July 2016: Revista Brasileira de Anestesiologia
Evan R Gedzelman, Suzette M LaRoche
Psychogenic nonepileptic seizures have long been known by many names. A short list includes hysteroepilepsy, hysterical seizures, pseudoseizures, nonepileptic events, nonepileptic spells, nonepileptic seizures, and psychogenic nonepileptic attacks. These events are typically misdiagnosed for years and are frequently treated as electrographic seizures and epilepsy. These patients experience all the side effects of antiepileptic drugs and none of the benefits. Video electroencephalogram (EEG) monitoring is the gold standard diagnostic test that can make a clear distinction between psychogenic nonepileptic seizures and epilepsy...
2014: Neuropsychiatric Disease and Treatment
Louwai Muhammed, Jane E Adcock, Arjune Sen
Medical students are increasingly turning to the website YouTube as a learning resource. This study set out to determine whether the videos on YouTube accurately depict the type of seizures that a medical student may search for. Two consultant epileptologists independently assessed the top YouTube videos returned following searches for eight terms relating to different categories of seizures. The videos were rated for their technical quality, concordance of diagnosis with an epileptologist-assigned diagnosis, and efficacy as a learning tool for medical education...
August 2014: Epilepsy & Behavior: E&B
Brian O'Shea
Our understanding of factitious disorders has expanded from that of medical and surgical exotica into that of a much broader psychiatric disorder. Patients can be divided into a nuclear group (classical Munchausen), a larger non-nuclear and less socially deviant group, and children involved by proxy. There are many aetiological theories, ranging from the psychoanalytic to the organic, and at least some cases are learned at home. Physicians and other professionals must be familiar with the general features of these disorders and have some idea of the potential breadth of presentation...
2003: International Journal of Psychiatry in Clinical Practice
Jayne Martlew, Jennifer Pulman, Anthony G Marson
BACKGROUND: Psychogenic non-epileptic seizures, also known as non-epileptic attack disorder (NEAD), have the outward appearance of epilepsy in the absence of physiological or electroencephalographic correlates. Non-epileptic seizures can occur in isolation or in combination with epileptic seizures. The development and maintenance of non-epileptic seizures has been well documented and there is a growing literature on the treatment of non-epileptic seizures which includes non-psychological (including anti-anxiety and antidepressant pharmacological treatment) and psychological therapies (including cognitive behavioural therapy (CBT), hypnotherapy and paradoxical therapy)...
2014: Cochrane Database of Systematic Reviews
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