Neurologist, 1 year’s experience, USA

2020 ◽  
pp. 278-281
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Inpatient Care ◽  
Psychiatric Inpatient ◽  
Epileptic Seizures ◽  
Severe Malnutrition ◽  
Post Traumatic Stress ◽  
Related Disorder ◽  
Behavioral Healthcare ◽  
Post Traumatic ◽  
Children And Young Adults ◽  
Chronic Nausea

This chapter discusses how a neurologist started a Psychogenic Non-Epileptic Seizures (PNES) clinic. As an Epileptologist, the Neurologist would be best equipped to care for children and young adults who present with non-epileptic seizures. Patients with PNES often fall through the cracks because their condition lies between the land of Psychiatry and Neurology. The Neurologist hoped to serve patients with PNES who were lost in the gap between traditional Neurology and behavioral healthcare. Six months after its inception, a patient came to the newly established PNES clinic. The Neurologist learned from the chart review that the patient had been in inpatient Psychiatry care on more than one occasion several years prior. She had been treated for Depression and Post-Traumatic Stress Disorder (PTSD) from repeated sexual and verbal abuse from a family member. Her somatic symptom–related disorder developed shortly after discharge from her first psychiatric inpatient care several years ago, which manifested as chest pain, dizziness, fainting, chronic nausea, chronic abdominal pain, eating disorder, severe malnutrition, headache, weakness, and PNES. The chapter then argues that each patient in the PNES clinic brings unique challenges that require a creative and individualized solution.

scholarly journals Environmental enrichment prevents the late effect of acute stress-induced fear extinction deficit: the role of hippocampal AMPA-GluA1 phosphorylation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Leonardo Santana Novaes ◽  
Letícia Morais Bueno-de-Camargo ◽  
Carolina Demarchi Munhoz
Keyword(s):  
Environmental Enrichment ◽  
Basolateral Amygdala ◽  
Acute Stress ◽  
Fear Memory ◽  
Fear Extinction ◽  
Post Traumatic Stress ◽  
Related Disorder ◽  
Memory Extinction ◽  
Post Traumatic

AbstractThe persistence of anxiety and the deficit of fear memory extinction are both phenomena related to the symptoms of a trauma-related disorder, such as post-traumatic stress disorder (PTSD). Recently we have shown that single acute restraint stress (2 h) in rats induces a late anxiety-related behavior (observed ten days after stress), whereas, in the present work, we found that the same stress impaired fear extinction in animals conditioned ten days after stress. Fourteen days of environmental enrichment (EE) prevented the deleterious effect of stress on fear memory extinction. Additionally, we observed that EE prevented the stress-induced increase in AMPA receptor GluA1 subunit phosphorylation in the hippocampus, but not in the basolateral amygdala complex and the frontal cortex, indicating a potential mechanism by which it exerts its protective effect against the stress-induced behavioral outcome.

Therapist with PNES, USA

2020 ◽  
pp. 282-286
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Mental Health ◽  
Private Practice ◽  
Epileptic Seizures ◽  
Mental Health Disorders ◽  
Health Conditions ◽  
Post Traumatic Stress ◽  
The World ◽  
Post Traumatic ◽  
Health Disorders ◽  
Anxiety Depression

This chapter examines the personal experience of a Therapist with Psychogenic Non-Epileptic Seizures (PNES). As a Therapist in private practice, the Therapist strongly believed that to end the stigma of mental health conditions, she needed to own her own mental health disorders. The Therapist could not sit across from her clients every day and tell them not to be ashamed of their debilitating Anxiety, Depression, or Post-Traumatic Stress Disorder (PTSD) and yet hide her own mental illness from the world. As such, the therapist spoke openly on social media about mental health and her own journey, and the Therapist shared positive messages about the disorders she treated—that is, until the therapist’s own experience crossed over from the garden variety “Anxiety and Depression” that she saw every day into a much less widely known disorder, PNES. Then, the Therapist became less of a Therapist and more of a patient, trying to maintain some sort of sanity and perspective afforded to her from her years of training as a therapist.

scholarly journals Stress and dementia

2014 ◽  
Vol 26 (8) ◽  
pp. 1235-1236 ◽  
Author(s):  
Colleen Doyle ◽  
David Dunt ◽  
Philip Morris
Keyword(s):  
Traumatic Stress ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Related Condition ◽  
Related Disorder ◽  
Close Relationship ◽  
Post Traumatic ◽  
Dsm Iv ◽  
The Subject ◽  
Traumatic Incident

The causes of dementia continue to be the subject of huge research efforts, and post-traumatic stress disorder (PTSD) has recently gained attention as a possible contributor. PTSD is considered to be present if the sufferer develops persistent re-experiencing, avoidance and emotional numbing and symptoms of increased arousal not present before the sufferer was exposed to a traumatic incident. PTSD is now classified in DSM-5 as a trauma- and stressor-related disorder, unlike DSM-IV where it was previously categorized as an anxiety disorder, lending it more prominence now as a stress-related condition. However, it remains placed near the anxiety, obsessive compulsive and dissociative disorders in recognition of the close relationship with these other diagnoses. The nosology of PTSD is interesting as the symptoms can vary considerably. Some individuals with PTSD exhibit anxious or fear-based symptoms, while others can experience anhedonic, dysphoric, aggressive or dissociative symptoms (American Psychiatric Association, 2013).

scholarly journals Functional MRI-based study of emotional experience in patients with psychogenic non-epileptic seizures: Protocol for an observational case-control study–EMOCRISES study

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262216
Author(s):  
Pierre Fauvé ◽  
Louise Tyvaert ◽  
Cyril Husson ◽  
Emmanuelle Hologne ◽  
Xiaoqing Gao ◽  
...  
Keyword(s):  
Resting State ◽  
Visual Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Emotional Experience ◽  
Brain Mri ◽  
Epileptic Seizures ◽  
Healthy Controls ◽  
Post Traumatic Stress ◽  
Functional Brain ◽  
Post Traumatic

Background Psychogenic non epileptic seizures (PNES) are a frequent, disabling and costly disorder for which there is no consensual caring. They are considered as a dissociative disorder and they share many common characteristics with post-traumatic stress disorder (PTSD). Nevertheless, their pathophysiology is still unclear. In this study, we plan to obtain new data comparing functional brain activity of participants suffering from PNES, from PTSD and healthy controls via functional brain MRI during resting state and under emotional visual stimulation. The protocol presented hereunder describes an observational study with no direct treatment implication. Nevertheless, it could lead to a better understanding of PNES and to identifying targets for specialised cares of post-traumatic or dissociative disorders, like repetitive transcranial magnetic stimulation. Methods & analysis This is a prospective, single-centre, interventional, non-randomized, open, controlled and exploratory clinical study. It will involve 75 adult French, right-handed women in 3 groups, either suffering from PNES or PTSD, or healthy controls. An informed consent will be signed by each participant. All of them will be given psychiatric tests to assess dissociation and alexithymia, psychopathological profile and history, and emotional recognition. Each participant will undergo a functional brain MRI. We will record anatomical images and five functional imaging sequences including emotional periodic oscillatory stimulation, standard emotional stimulation, Go / No Go task under emotional stimulation, and resting state. Analysis will include a descriptive analysis of all participants and the treatment for functional magnetic resonance imaging images of each sequence. Registration, ethics & dissemination This study was approved the regional Protection of Persons Committee under the reference 16.10.01 and by the French National Medical Security Agency under the reference 2016-A01295-46. The protocol and results will be published in peer-reviewed academic medical journals and disseminated to research teams, databases, specialised media and concerned patients’ organisations.

Post-traumatic stress disorder: update on diagnosis and treatment

2021 ◽  
pp. 1-3
Author(s):  
Joshua C. Morganstein ◽  
Gary H. Wynn ◽  
James C. West
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Stress Disorder ◽  
Diagnosis And Treatment ◽  
Current Evidence ◽  
Post Traumatic Stress ◽  
Related Disorder ◽  
Current State ◽  
Post Traumatic

SUMMARY Post-traumatic stress disorder (PTSD) is a common trauma and stressor-related disorder. Trauma-focused psychotherapies and selective serotonin reuptake inhibitors represent current state of the art treatment for PTSD, with current evidence favouring psychotherapy as first-line treatment. Much room remains for development of more effective therapeutics. This article give a brief update on diagnosis and treatment of PTSD.

scholarly journals (Re)contextualizing the Trauma to Prevent or Treat PTSD-Related Hypermnesia

2021 ◽  
Vol 5 ◽  
pp. 247054702110210
Author(s):  
Aline Desmedt
Keyword(s):  
Traumatic Memory ◽  
Post Traumatic Stress ◽  
Related Disorder ◽  
Memory Processing ◽  
Traumatic Amnesia ◽  
Related Symptom ◽  
Post Traumatic ◽  
Mixed Efficacy ◽  
Fear And Anxiety ◽  
Cardinal Feature

A cardinal feature of Post-traumatic stress-related disorder (PTSD) is a paradoxical memory alteration including both intrusive emotional hypermnesia and declarative/contextual amnesia. Most preclinical, but also numerous clinical, studies focus almost exclusively on the emotional hypermnesia aiming at suppressing this recurrent and highly debilitating symptom either by reducing fear and anxiety or with the ethically questionable idea of a rather radical erasure of traumatic memory. Of very mixed efficacy, often associated with a resurgence of symptoms after a while, these approaches focus on PTSD-related symptom while neglecting the potential cause of this symptom: traumatic amnesia. Two of our preclinical studies have recently demonstrated that treating contextual amnesia durably prevents, and even treats, PTSD-related hypermnesia. Specifically, promoting the contextual memory of the trauma, either by a cognitivo-behavioral, optogenetic or pharmacological approach enhancing a hippocampus-dependent memory processing of the trauma normalizes the fear memory by inducing a long-lasting suppression of the erratic traumatic hypermnesia.

Firefighter With Co-Morbid Psychogenic Non-Epileptic Seizures and Post-Traumatic Stress Disorder Treated With Prolonged Exposure Therapy: Long-Term Follow-Up

2020 ◽  
pp. 153465012096318
Author(s):  
Lorna Myers ◽  
Robert Trobliger ◽  
Shanneen Goszulak
Keyword(s):  
Seizure Frequency ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Epileptic Seizures ◽  
Psychological Trauma ◽  
Post Traumatic Stress ◽  
Post Traumatic

Psychogenic non-epileptic seizures (PNES), are events that resemble epileptic seizures but lack electrophysiological or clinical evidence for epilepsy. Instead, they are psychogenic in origin. These episodes tend to occur with alterations in consciousness and bodily functions and are the result of mechanisms of conversion. Psychological trauma and post-traumatic stress disorder (PTSD) are prevalent among patients with PNES. This is a case report of a 32-year-old male who began treatment 1-year after developing PTSD followed some months later by PNES. His seizures were characterized by contorted movements of the head and neck, guttural sounds, and left sided movements or whole-body arching and were accompanied by frequent falls and injuries. They were usually brief but occurred daily. Psychotherapy had been discontinued because violent seizures often interrupted the sessions. He was treated with prolonged exposure (PE) at a PNES program and by the last session, had achieved an improvement in his seizure frequency (one every 4–6 days rather than daily episodes). This allowed him to begin therapy with a local therapist. Two years after completing treatment, the patient returned for a follow up visit. At that point, his seizure frequency, was one per month which shows he sustained and improved on this symptom. Former head drops, and grunting sounds disappeared, and he was no longer using a cane to ambulate. From an emotional standpoint (PTSD, suicidality, anxiety, quality of life), the patient had achieved and maintained a much healthier level of functioning (though no change on alexithymia, anger, depression, and trait anxiety).

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