Prolonged Exposure Therapy for Comorbid Psychogenic Nonepileptic Seizures and Posttraumatic Stress Disorder

2017 ◽  
Vol 17 (1) ◽  
pp. 3-20 ◽  
Author(s):  
Lorna Myers ◽  
Laurie Zandberg
Keyword(s):  
Posttraumatic Stress ◽  
Prolonged Exposure ◽  
Epileptic Seizures ◽  
Psychological Trauma ◽  
Psychogenic Nonepileptic Seizures ◽  
Full Remission ◽  
Stress Symptoms ◽  
Prolonged Exposure Therapy ◽  
History Of ◽  
Nonepileptic Seizures

Psychogenic nonepileptic seizures (PNES) superficially resemble epileptic seizures but are not associated with epileptic discharges in the brain. Instead, these episodes, which tend to occur with alterations in consciousness and body movements, are thought to be the result of mechanisms of conversion and dissociation. Psychological trauma and PTSD are very prevalent among patients with PNES. PNES can be conceived of as an extreme avoidance mechanism that serves the function of modulating distress and, in some cases, eliminating the precipitant stressor. Avoidance is also an essential component of PTSD. In patients who carry a dual diagnosis of PNES and PTSD, it is sensible that an empirically validated treatment for PTSD such as prolonged exposure (PE) therapy which targets avoidance by promoting exposure might be a useful approach to treat these patients. In this report, we present the case of a 52-year-old male with a 7-year history of PNES. His seizures, which were characterized by intense body shaking and loud guttural outbursts, were occurring up to 15 times per day. Because of these symptoms, he lost his employment and was ostracized by his family. Upon completion of a course of intensive outpatient PE, he achieved full remission of all psychogenic symptoms. Except for three brief seizures, he has maintained his health for 2 years. This constitutes the first detailed report of PE therapy used to effectively treat comorbid PNES and posttraumatic stress symptoms.

scholarly journals Using Psychedelics With Therapeutic Intent Is Associated With Lower Shame and Complex Trauma Symptoms in Adults With Histories of Child Maltreatment

2021 ◽  
Vol 5 ◽  
pp. 247054702110298
Author(s):  
C. J. Healy ◽  
Kellie Ann Lee ◽  
Wendy D’Andrea
Keyword(s):  
Social Cognition ◽  
Child Maltreatment ◽  
Posttraumatic Stress ◽  
Complex Trauma ◽  
Self Concept ◽  
Posttraumatic Stress Symptoms ◽  
Trauma Symptoms ◽  
Internalized Shame ◽  
Stress Symptoms ◽  
History Of

Background Child maltreatment negatively affects the formation of internal schemata of self and other during development, leading to negative adaptations in self-concept and social cognition. Clinical reports suggest the efficacy of psychedelics in treating the psychopathological sequelae of child maltreatment. Altering maladaptive schemata of self and other implicated in negative self-concept and impaired social cognition may be a central mechanism for reducing posttraumatic stress symptoms. Aims This study aims to assess whether psychedelic use moderates the relationships between child maltreatment and self-concept, social cognition, and posttraumatic stress symptoms. Method An online survey was completed by 166 participants and included measures of maltreatment exposure and severity, history of intentional therapeutic psychedelic use, posttraumatic stress symptoms, internalized shame, and facial emotion recognition. Results Child maltreatment significantly correlated with posttraumatic stress symptoms ( r = .26 and r = .20, p < .01) and internalized shame ( r = .18, p < .05). Of all maltreatment subtypes, emotional abuse and neglect most strongly correlated with complex trauma symptoms ( r = .32, p < .001) and internalized shame ( r = .31, p < .001). Participants with a history of intentional therapeutic psychedelic use reported significantly lower complex trauma symptoms ( d = 0.33, p < .05) and internalized shame ( d = 0.35, p < .05) despite similar histories of maltreatment. Differences in complex trauma symptoms ( d = 0.66, p < .01) and internalized shame ( d = 0.80, p < .001) were largest for participants with a history of more than 5 occasions of intentional therapeutic psychedelic use. A history of more than 5 occasions of intentional therapeutic psychedelic use significantly moderated the relationship between emotional abuse and neglect and complex trauma symptoms (p < .01). No associations were found between maltreatment or psychedelic use and facial emotion recognition. Conclusion These findings demonstrate that using psychedelic drugs with therapeutic intent is associated with lower levels of complex trauma symptoms and internalized shame in individuals with histories of child maltreatment. Psychedelic use may have therapeutic benefit in treating the posttraumatic sequelae of child maltreatment.

scholarly journals Neuropsychological aspects of psychogenic nonepileptic seizures

2007 ◽  
Vol 13 (4 suppl 1) ◽  
pp. 24-27
Author(s):  
Mirna Wetters Portuguez ◽  
Danielle Irigoyen da Costa ◽  
Sabine Possa Marroni ◽  
Vanessa Pagliarini ◽  
Karin Vieira
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Multidisciplinary Team ◽  
Emotional Abuse ◽  
Epileptic Seizures ◽  
Mental Processes ◽  
Psychogenic Nonepileptic Seizures ◽  
Therapeutic Procedures ◽  
Nonepileptic Seizures ◽  
The Brain

Psychogenic nonepileptic seizures (PNES) may be defined as paroxysmal changes in behavior that are similar to epileptic seizures but are not associated with quantifiable alterations in the electrical activity of the brain. At the Epilepsy Surgery Program (ESP) of the São Lucas Hospital at PUCRS (HSL-PUCRS), we studied 52 individuals (37 females and 15 males) with a diagnosis of PNES, associated (57%) or not (23%) with refractory epileptic seizures. We found emotional abuse (100%), physical abuse (80%), emotional neglect (80%), physical negligence (70%) and sexual abuse (30%), mood (40%) and anxiety disorders (50%), as the main psychological components in such population. Although the medical and psychosocial impact of PNES can be estimated as significant, the absence of specialized services for its treatment is striking. Multiple diagnostic and therapeutic procedures and the participation of a specialized multidisciplinary team – where neuropsychology functions as a link between the mental processes/psychopathologies and the brain – are required to ensure proper management of such cases.

Paroxetine CR Augmentation for Posttraumatic Stress Disorder Refractory to Prolonged Exposure Therapy

2008 ◽  
Vol 69 (3) ◽  
pp. 400-405 ◽  
Author(s):  
Naomi M. Simon ◽  
Kathryn M. Connor ◽  
Ariel J. Lang ◽  
Sheila Rauch ◽  
Stan Krulewicz ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Exposure Therapy ◽  
Prolonged Exposure Therapy

scholarly journals Spectrum of Nonepileptic Paroxysmal Events in Children from Southern India

2019 ◽  
Vol 10 (04) ◽  
pp. 608-612
Author(s):  
Vykuntaraju K Gowda ◽  
Raghavendraswami Amoghimath ◽  
Naveen Benakappa ◽  
Sanjay K Shivappa
Keyword(s):  
Children And Adolescents ◽  
Age Of Onset ◽  
Age Groups ◽  
Epileptic Seizures ◽  
Breath Holding ◽  
Home Video ◽  
Psychogenic Nonepileptic Seizures ◽  
Wrong Diagnosis ◽  
Nonepileptic Seizures ◽  
Eeg Recordings

Abstract Background Nonepileptic paroxysmal events (NEPEs) present with episodes similar to epileptic seizures but without abnormal electrical discharge on electroencephalogram (EEG). NEPEs are commonly misdiagnosed as epilepsy. Epilepsy is diagnosed on the basis of a detailed history and examination. Emphasis during history to rule out the possibility of NEPE is important. The wrong diagnosis of epilepsy can lead to physical, psychological, and financial harm to the child and the family. Hence, this study was planned. Objective The objective of the study is to evaluate clinical profile, frequency, and spectrum of NEPE in children. Materials and Methods This is a prospective observational study. Patients with NEPE between January 2014 and August 2016 aged < 18 years were enrolled. NEPEs were diagnosed on the basis of history, home video, and EEG recordings. Patients were divided into different categories according to age, specific type of disorder, and system responsible. Patients were followed for their NEPE frequency and outcome. Results A total of 3,660 children presented with paroxysmal events; of them 8% were diagnosed with NEPE. Patients diagnosed with NEPE were classified into three age groups on the basis of their age of onset of symptom; of the total 285 patients, there were 2 neonates (0.7%), 160 infants (56%), and 123 children and adolescents (43.1%). Fifty-eight percent patients were boys. The most common diagnoses were breath-holding spells 113 (39%), followed by syncope 38 (13.3%) and psychogenic nonepileptic seizures 37 (12.9%). About 9 and 5% of patients had concomitant epilepsy and developmental delay, respectively. Conclusions NEPEs account for 8% of paroxysmal events. Most common NEPEs were breath-holding spells among infants and syncope and “psychogenic nonepileptic seizures” in children and adolescents.

Validity testing in veterans with epileptic seizures and psychogenic nonepileptic seizures

2020 ◽  
Vol 111 ◽  
pp. 107246 ◽  
Author(s):  
Martin Salinsky ◽  
Laurence Binder ◽  
Daniel Storzbach ◽  
Karen Parko ◽  
Paul Rutecki ◽  
...  
Keyword(s):  
Epileptic Seizures ◽  
Validity Testing ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures
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