Nonepileptic Events

2017 ◽  
Author(s):  
David K. Chen ◽  
W. Curt LaFrance
Keyword(s):  
Conversion Disorder ◽  
Evidence Based ◽  
Drug Resistant ◽  
Significant Morbidity ◽  
Psychogenic Nonepileptic Seizures ◽  
Clinical Evaluations ◽  
Evidence Based Treatments ◽  
Nonepileptic Seizures ◽  
Drug Resistant Epilepsy ◽  
Underlying Pathology

Nonepileptic events (NEE) represent important differential diagnoses in patients with neurobehavioral paroxysms, especially those with apparent drug-resistant epilepsy. Errant recognition of NEE may not only subject the patient to potential complications of unnecessary epilepsy treatment, but delay the delivery of treatment that properly addresses the underlying pathology. For many patients with NEE, such as those with the conversion disorder psychogenic nonepileptic seizures (PNES) or with physiologic NEE (e.g., cardiac-induced syncope), delays in the provision of proper treatment have been shown to be associated with significant morbidity. This review focuses on clinical evaluations aiming to enhance the recognition of the different etiologies of NEE and distinguish between NEE and epilepsy, as well as between NEE of varying pathologies. Evidence-based treatments and management of NEE, particularly those pertaining to PNES, will also be discussed.

Psychogenic Nonepileptic Seizures in Women

2017 ◽  
Vol 37 (06) ◽  
pp. 624-631 ◽  
Author(s):  
Gaston Baslet ◽  
Barbara Dworetzky
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Traumatic Experiences ◽  
Clinical Approach ◽  
Evidence Based ◽  
Accurate Identification ◽  
Psychogenic Nonepileptic Seizures ◽  
Evidence Based Treatments ◽  
Nonepileptic Seizures ◽  
The Difference

AbstractPsychogenic nonepileptic seizures (PNES) are the most common type of functional neurological symptom disorders and are frequently diagnosed in tertiary care epilepsy monitoring units. These are associated with significant decline in social functioning and quality of life. The majority of patients with PNES are women, outnumbering men by a ratio of 3:1. Female sex preponderance occurs after puberty and usually before the age of 55 years. Many of the psychiatric risk factors in PNES (depression, anxiety, history of traumatic experiences, other somatic symptom disorders) are more common in women and may partially account for the difference in sex prevalence. Neurobiological and neurohumoral mechanisms may also play a role, but our understanding is limited at this point. In this review, we present information on epidemiology and risk factors, neurobiological and psychological mechanisms, clinical approach to diagnosis, evidence-based treatment, and long-term outcomes. We highlight findings related to differences between women and men in PNES. Most of these data are not decisive and require further corroboration. While the disorder may be more frequently suspected in women, all patients with suspected PNES deserve an objective and thorough investigation of their symptoms. Early and accurate identification of this disorder should be a priority, especially as evidence-based treatments, which may lead to improved outcomes, are increasingly available.

Psychiatric disorders in patients with psychogenic nonepileptic seizures and drug-resistant epilepsy: A study of an Argentine population

2013 ◽  
Vol 29 (1) ◽  
pp. 155-160 ◽  
Author(s):  
Laura Scévola ◽  
Julia Teitelbaum ◽  
Silvia Oddo ◽  
Estela Centurión ◽  
César Fabián Loidl ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Drug Resistant ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures ◽  
Drug Resistant Epilepsy

scholarly journals Characteristics of Children Hospitalized for Psychogenic Nonepileptic Seizures Due to Conversion Disorder Versus Epilepsy

2018 ◽  
Vol 8 (6) ◽  
pp. 321-329 ◽  
Author(s):  
Sarah K. Luthy ◽  
Angela F. Moss ◽  
Michelle R. Torok ◽  
Lisa McLeod ◽  
Karen M. Wilson
Keyword(s):  
Conversion Disorder ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures

Evidence-Based Treatments

2017 ◽  
Author(s):  
W. Curt LaFrance ◽  
Laura H. Goldstein
Keyword(s):  
Treatment Options ◽  
Controlled Trials ◽  
Limited Sample ◽  
Future Studies ◽  
Psychogenic Nonepileptic Seizures ◽  
The Past ◽  
Evidence Based Treatments ◽  
Nonepileptic Seizures ◽  
New Treatment ◽  
Functional Neurological Disorders

Psychogenic nonepileptic seizures (PNES) have been in the medical literature for centuries. However, treatments were limited, being based on uncontrolled data, until the past decade. Treatment advances published since 2010 have included pilot controlled trials using psychotherapies, psychoeducational approaches, medications, and combined pharmacological and psychotherapeutic approaches that provide new treatment options for patients with PNES. This chapter describes these controlled trials in detail. It also covers studies of treatments for other functional neurological disorders including PNES. One conclusion from this review is that future studies still need to improve on as-yet limited sample sizes and provide insights into predictors of treatment outcome so that rational decisions can be made about which treatments offer the best outcome and who is likely to best respond to which treatment.

scholarly journals Closed-Loop Brain Stimulation for Drug-Resistant Epilepsy: Towards an Evidence-Based Approach to Personalized Medicine

2018 ◽  
Vol 16 (1) ◽  
pp. 119-127 ◽  
Author(s):  
Nathaniel D. Sisterson ◽  
Thomas A. Wozny ◽  
Vasileios Kokkinos ◽  
Alexander Constantino ◽  
R. Mark Richardson
Keyword(s):  
Personalized Medicine ◽  
Brain Stimulation ◽  
Closed Loop ◽  
Evidence Based ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

Quantitative EEG Findings in Patients With Psychogenic Nonepileptic Seizures

2020 ◽  
pp. 155005942091875
Author(s):  
Kemal Arıkan ◽  
Özden Öksüz ◽  
Barış Metin ◽  
Güven Günver ◽  
Hamide Laçin Çetin ◽  
...  
Keyword(s):  
Spectral Power ◽  
Clinical Manifestations ◽  
Conversion Disorder ◽  
Quantitative Eeg ◽  
Control Group ◽  
Fast Fourier Transformation ◽  
Psychogenic Nonepileptic Seizures ◽  
Epileptiform Discharges ◽  
Nonepileptic Seizures ◽  
High Beta

Objective. Psychogenic nonepileptic seizures (PNES), is one of the clinical manifestations of conversion disorder that epileptiform discharges do not accompany. Factors capable of increasing susceptibility to these seizures have not been adequately investigated yet. This study aims to investigate the quantitative electroencephalography (QEEG) findings for PNES by evaluating the resting EEG spectral power changes during the periods between seizures. Methods. Thirty-nine patients (29 females, 10 males) diagnosed with PNES (group 1) and 47 patients (23 females, 24 males) without any psychiatric diagnosis (group 2) were included in the study. The patients underwent a psychiatric examination at their first visit, were diagnosed and their EEGs were recorded. Using fast Fourier transformation (FFT), spectral power analysis was calculated for delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (15-30 Hz), high-beta (25-30 Hz), gamma-1 (31-40 Hz), gamma-2 (41-50 Hz), and gamma (30-80 Hz) frequency bands. Results. Six separate EEG band power, namely (C3-high beta, C3-gamma, C3-gamma-1, C3-gamma-2, P3-gamma, P3 gamma-1), were found to be higher in the patients diagnosed with PNES than in the control group. Conclusion. Our findings show that PNES correlate with high-frequency oscillations on central motor and somatosensory cortices.

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