Eye movement desensitization and reprocessing treatment in functional neurological symptom disorder with psychogenic nonepileptic seizures: A study of two cases

2021 ◽  
pp. 135910452110372
Author(s):  
Onur O Demirci ◽  
Eser Sagaltici
Keyword(s):  
Psychiatric Disorders ◽  
Eye Movement ◽  
Neurological Symptom ◽  
Term Treatment ◽  
Post Traumatic Stress ◽  
Psychogenic Nonepileptic Seizures ◽  
Long Term Treatment ◽  
Scale Scores ◽  
Nonepileptic Seizures ◽  
Functional Neurological Symptom Disorder

Patients with functional neurological symptom disorder (FND) have many diverse symptoms including psychogenic nonepileptic seizures (PNES), positive movements such as tremor, dystonia, or gait abnormalities, loss of motor function such as leg or arm paresis, and loss of sensory functions, such as blindness, deafness, or loss of feeling in the limbs. Eye movement desensitization and reprocessing (EMDR) is a therapy method that includes some techniques arising from psychodynamic, cognitive, and behavioral approaches. EMDR is known as a proven psychotherapeutic approach in post-traumatic stress disorder, but there are also numerous studies reporting its efficacy in other psychiatric disorders and trauma-associated symptoms, in patients with comorbid psychiatric disorders. This article presents the outcome of EMDR treatment of two patients’ cases, a 13-year-old female and a 16-year-old male, who were diagnosed as FND with PNES, according to the DSM-5 diagnostic criteria. In both cases, there was a significant decrease in Adolescent Dissociative Experiences Scale scores and no pseudo seizures were found, even at the sixth-month follow-up visits. These case studies suggest that EMDR can be an effective method in the long-term treatment of FND with PNES and a useful alternative to other treatment methods.

Mechanisms of Possible Neurocognitive Dysfunction

2017 ◽  
Author(s):  
Daniel L. Drane ◽  
Dona E. C. Locke
Keyword(s):  
Neuropsychological Testing ◽  
Psychological Theory ◽  
Future Research ◽  
Performance Validity ◽  
Post Traumatic Stress ◽  
Neurocognitive Dysfunction ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures ◽  
Performance Validity Measures ◽  
Validity Tests

This chapter covers what is known about the possible mechanisms of neurocognitive dysfunction in patients with psychogenic nonepileptic seizures (PNES). It begins with a review of all research examining possible cognitive deficits in this population. Cognitive research in PNES is often obscured by noise created by a host of comorbid conditions (e.g., depression, post-traumatic stress disorder, chronic pain) and associated issues (e.g., effects of medications and psychological processes that can compromise attention or broader cognition). More recent studies employing performance validity tests raise the possibility that studies finding broad cognitive problems in PNES may be highlighting a more transient phenomenon secondary to these comorbid or secondary factors. Such dysfunction would likely improve with successful management of PNES symptomatology, yet the effects of even transient variability likely compromises daily function until these issues are resolved. Future research must combine the use of neuropsychological testing, performance validity measures, psychological theory, neuroimaging analysis, and a thorough understanding of brain–behavior relationships to address whether there is a focal neuropathological syndrome associated with PNES.

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

Quality of life in schizophrenia: Long-term follow-up in 362 chronic Spanish schizophrenic outpatients undergoing risperidone maintenance treatment

1998 ◽  
Vol 13 (3) ◽  
pp. 158-163 ◽  
Author(s):  
J Bobes ◽  
M Gutiérrez ◽  
J Gibert ◽  
MP González ◽  
L Herraiz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Term Treatment ◽  
Four Dimensions ◽  
Sf 36 ◽  
Long Term Treatment ◽  
Scale Scores ◽  
History Of Use ◽  
Schizophrenic Outpatients

SummaryOur aim was to determine the effect of risperidone monotherapy treatment on disability and on the quality of life of 318 schizophrenic outpatients who had been previously treated with other neuroleptics. Patients were assessed at baseline 2, 4 and 8 months using the BPRS, CGI, WHO/DDS and SF-36. BPRS scores showed a significant decrease at month 2, both in the total score and in each of the three clusters, negative, positive and depression/anxiety. WHO/DDS scores significantly decreased both in the overall score (from 51.8 to 37.4, P < 0.0001) and in the four dimensions. SF-36 scale scores and summary measures showed a significant improvement after 8 months of risperidone treatment. Risperidone long-term treatment (8 months) has a positive effect on clinical and on psychosocial outcomes. Females, paranoids patients and patients without history of use-abuse of substances showed greater improvements in quality of life.

Treatment duration of psychiatric disorders: long-term treatment of resistant schizophrenia

1993 ◽  
Vol 8 (6) ◽  
pp. 281-283 ◽  
Author(s):  
JM Kane
Keyword(s):  
Psychiatric Disorders ◽  
Treatment Duration ◽  
Term Treatment ◽  
Antipsychotic Medications ◽  
Long Term Treatment ◽  
Term Management

SummaryAlthough antipsychotic medications are extremely valuable in both the acute and long-term management of schizophrenia, a substantial subgroup of patients derive little or only partial benefit. A variety of strategies to treat such patients are reviewed.

scholarly journals Neurological disorder-associated genetic variants in individuals with psychogenic nonepileptic seizures

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Costin Leu ◽  
Jocelyn F. Bautista ◽  
Monica Sudarsanam ◽  
Lisa-Marie Niestroj ◽  
Arthur Stefanski ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Genetic Variants ◽  
Large Scale ◽  
Genetic Factors ◽  
Tertiary Care ◽  
Genetic Research ◽  
Genetic Investigation ◽  
Psychogenic Nonepileptic Seizures ◽  
Whole Exome ◽  
Nonepileptic Seizures

Abstract Psychogenic nonepileptic seizures (PNES) are diagnosed in approximately 30% of patients referred to tertiary care epilepsy centers. Little is known about the molecular pathology of PNES, much less about possible underlying genetic factors. We generated whole-exome sequencing and whole-genome genotyping data to identify rare, pathogenic (P) or likely pathogenic (LP) variants in 102 individuals with PNES and 448 individuals with focal (FE) or generalized (GE) epilepsy. Variants were classified for all individuals based on the ACMG-AMP 2015 guidelines. For research purposes only, we considered genes associated with neurological or psychiatric disorders as candidate genes for PNES. We observe in this first genetic investigation of PNES that six (5.88%) individuals with PNES without coexistent epilepsy carry P/LP variants (deletions at 10q11.22-q11.23, 10q23.1-q23.2, distal 16p11.2, and 17p13.3, and nonsynonymous variants in NSD1 and GABRA5). Notably, the burden of P/LP variants among the individuals with PNES was similar and not significantly different to the burden observed in the individuals with FE (3.05%) or GE (1.82%) (PNES vs. FE vs. GE (3 × 2 χ2), P = 0.30; PNES vs. epilepsy (2 × 2 χ2), P = 0.14). The presence of variants in genes associated with monogenic forms of neurological and psychiatric disorders in individuals with PNES shows that genetic factors are likely to play a role in PNES or its comorbidities in a subset of individuals. Future large-scale genetic research studies are needed to further corroborate these interesting findings in PNES.

Psychiatric Disorders in Children and Adolescents With Psychogenic Nonepileptic Seizures

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012270
Author(s):  
Anne Sofie Hansen ◽  
Charlotte Ulrikka Rask ◽  
Ann-Eva Christensen ◽  
Maria Rodrigo-Domingo ◽  
Jakob Christensen ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Psychiatric Disorders ◽  
Wide Spectrum ◽  
Psychiatric Evaluation ◽  
Healthy Controls ◽  
Psychogenic Nonepileptic Seizures ◽  
Relative Risks ◽  
Wide Range ◽  
Comparison Groups ◽  
Nonepileptic Seizures

Objective:Knowledge regarding psychiatric disorders in children and adolescents with psychogenic nonepileptic seizures (PNES) is limited. This study outlines the spectrum and risk of psychiatric disorders in childhood-onset PNES.Methods:A nationwide matched cohort study of children and adolescents with PNES aged 5-17 years at time of diagnosis between January 1, 1996 and December 31, 2014. Two matched comparison groups were included: children and adolescents with epilepsy (ES), and children and adolescents without PNES or epilepsy, termed healthy controls (HC). Outcomes were prevalent psychiatric disorders prior to index (i.e. date of diagnosis or corresponding date for HCs), and incident psychiatric disorders two years after index. Relative risks (RRs) were calculated and adjusted for potential confounders.Results:We included 384 children and adolescents with validated PNES, 1,152 with epilepsy, and 1,920 healthy controls. Among the PNES cases, 153 (39.8%) had prevalent psychiatric disorders and 150 (39.1%) incident psychiatric disorders. As compared to the epilepsy and healthy controls, children and adolescents with PNES had elevated risks of both prevalent psychiatric disorders (adjusted RRPNES/ES: 1.87, 95% CI: 1.59–2.21, adjusted RRPNES/HC: 5.54, 95% CI: 4.50–6.81), and incident psychiatric disorders (adjusted RRPNES/ES: 2.33, 95% CI: 1.92–2.83, adjusted RRPNES/HC: 8.37, 95% CI: 6.31–11.11). A wide spectrum of specific psychiatric disorders displayed elevated RRs.Conclusions:Children and adolescents with PNES are at higher risk of a wide range of psychiatric disorders as compared to children and adolescents with epilepsy and healthy controls. A careful psychiatric evaluation is warranted to optimize and individualize treatment.

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