Neuropsychological aspects of psychogenic nonepileptic seizures

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 â€“ where neuropsychology functions as a link between the mental processes/psychopathologies and the brain â€“ are required to ensure proper management of such cases.

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Pszichogén nem epilepsziás rosszullétek a klinikai gyakorlatban

Orvosi Hetilap ◽

10.1556/650.2016.30428 ◽

2016 ◽

Vol 157 (20) ◽

pp. 767-775 ◽

Cited By ~ 1

Author(s):

Bernadett Szita ◽

Zoltán Hidasi

Keyword(s):

Behavioral Therapy ◽

Early Adulthood ◽

Epileptic Seizures ◽

Pharmacological Interventions ◽

Psychogenic Nonepileptic Seizures ◽

Traumatic Life Events ◽

High Prevalence ◽

Nonepileptic Seizures ◽

The Brain ◽

Video Eeg

Psychogenic nonepileptic seizures are enigmatic disorders at the interface of neurology and psychiatry. Seizures resemble epileptic seizures but are not associated with electrical discharges in the brain. Symptoms typically start in early adulthood and women are far more affected than men. Video-EEG is widely considered to be the gold standard for diagnosis. Still psychogenic nonepileptic seizures are often misdiagnosed and treated as epilepsy for years that is burdensome to patients and costly to the healthcare system. Patients having psychogenic nonepileptic seizures show a high prevalence of traumatic life events, therefore, psychosocial factors are thought to play an important role in the etiology. Neurobiological factors may also contribute to the development of seizures as a subgroup of patients are characterized by cognitive impairment and subtle structural and functional brain abnormalities. Treatment includes psychotherapeutic procedures, particularly cognitive behavioral therapy and additional pharmacological interventions. This article presents an overview of the clinical context, diagnosis, etiology and treatment of psychogenic nonepileptic seizures. Orv. Hetil., 2016, 157(20), 767–775.

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Pseudoseizure with Pseudo-ventricular Tachycardia

European Journal of Arrhythmia & Electrophysiology ◽

10.17925/ejae.2018.04.01.28 ◽

2018 ◽

Vol 04 (01) ◽

pp. 28

Author(s):

Ozlem Karabulut ◽

Ozcan Ozeke ◽

Ilke Erbay ◽

Ertan Ekici ◽

Serkan Cay ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Body Movement ◽

Epileptic Seizures ◽

Clinical History ◽

Careful Analysis ◽

Interesting Case ◽

Psychological Disturbance ◽

Psychogenic Nonepileptic Seizures ◽

Nonepileptic Seizures ◽

The Brain

Psychogenic nonepileptic seizures (PNES), or pseudoseizures, are paroxysmal episodes that resemble, and are often misdiagnosed as, epileptic seizures; however, they are psychological (i.e., emotional, stress-related) in origin. Unlike epileptic seizures, PNES do not result from an abnormal electrical discharge from the brain; they are a physical manifestation of a psychological disturbance. We present an interesting case of PNES with pseudo-ventricular tachycardia due to body movement related artefacts. A careful analysis of the whole 12-lead electrocardiogram is required to rule out an artefact-related appearance of ventricular tachycardia. Correct interpretation of electrocardiograms and their co-relation to clinical history and presentation is key.

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Safeguarding children

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738021995851 ◽

2021 ◽

pp. 175573802199585

Author(s):

Sabana Shaikh ◽

Rubena Ali Malik

Keyword(s):

Sexual Abuse ◽

Child Abuse ◽

Healthcare Professional ◽

Physical Abuse ◽

Emotional Abuse ◽

Multidisciplinary Meetings ◽

The Family ◽

Abuse And Neglect ◽

Psychological Harm

It is the duty of every healthcare professional to ensure they prioritise the welfare of a child by protecting them from physical or psychological harm. Forms of child abuse include physical abuse, emotional abuse, sexual abuse and neglect. A child subjected to emotional abuse or neglect can present with ambiguous symptoms, making the abuse difficult to detect. Safeguarding concerns must be acted upon according to local procedures, guided by the child safeguarding lead and the practice safeguarding policy. Safeguarding multidisciplinary meetings can be an effective way of communicating with various professionals involved with the family.

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Epilepsy and Related Disorders

10.2310/neuro.1244 ◽

2018 ◽

Author(s):

Barbara Dworetzky ◽

Jong Woo Lee

Keyword(s):

Differential Diagnosis ◽

Generic Drugs ◽

Sudden Change ◽

Epileptic Seizures ◽

Quality Measures ◽

The Elderly ◽

Childhood And Adolescence ◽

Nonepileptic Seizures ◽

Infancy And Early Childhood ◽

The Brain

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy. This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures

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Students Affected by Physical and Emotional Abuse

Supporting and Educating Traumatized Students ◽

10.1093/med:psych/9780199766529.003.0015 ◽

2012 ◽

pp. 219-228

Author(s):

Lisa Wegman ◽

A. Michelle O’Banion

Keyword(s):

Sexual Abuse ◽

Physical Abuse ◽

Emotional Abuse ◽

Psychological Maltreatment ◽

Child Protective Service ◽

Protective Service ◽

K 12 ◽

Service Agencies

Abuse and maltreatment of children is a growing statistic. Each year, more than 3 million reports of alleged maltreatment are made to Child Protective Service agencies, suggesting that approximately six million children, or 11% of all U.S. students in K-12 schools, experience some form of maltreatment annually.8 While not all reported cases are investigated or substantiated, many instances of maltreatment go unreported; thus, the prevalence of maltreatment may be even higher. There are at least four major types of maltreatment: physical abuse, emotional abuse (or psychological maltreatment), neglect, and sexual abuse. It is important to note that these forms of maltreatment can occur separately or in combination with another. Given the unique characteristics and consequences associated with these various forms of maltreatment, this chapter will focus primarily on physical and emotional abuse. Other chapters in this volume will discuss sexual abuse (Chapter 13) and neglect (Chapter 14) in more details – readers working with students affected by physical and emotional abuse are encouraged to also review both of these other chapters for additional strategies.

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Differentiating psychogenic nonepileptic seizures from epileptic seizures: An observational study of patients undergoing video-electroencephalography (VEEG) in Australia

Epilepsy & Behavior ◽

10.1016/j.yebeh.2020.107542 ◽

2020 ◽

pp. 107542

Author(s):

Maryon Jones ◽

Jared Gaskell ◽

Alexander Lehn

Keyword(s):

Observational Study ◽

Epileptic Seizures ◽

Psychogenic Nonepileptic Seizures ◽

Nonepileptic Seizures

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Spectrum of Nonepileptic Paroxysmal Events in Children from Southern India

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0039-3399472 ◽

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.

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Sexual abuse and psychogenic nonepileptic seizures

Neurological Sciences ◽

10.1007/s10072-019-03887-3 ◽

2019 ◽

Vol 40 (8) ◽

pp. 1607-1610 ◽

Cited By ~ 3

Author(s):

Ali A. Asadi-Pooya ◽

Zahra Bahrami

Keyword(s):

Sexual Abuse ◽

Psychogenic Nonepileptic Seizures ◽

Nonepileptic Seizures

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Barriers to disclosure of child maltreatment among school-going adolescent girls of a semi-urban area of Delhi, India

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2016-0014 ◽

2016 ◽

Vol 29 (6) ◽

Cited By ~ 2

Author(s):

Shailaja Daral ◽

Anita Khokhar ◽

Shishir Kumar Pradhan

Keyword(s):

Sexual Abuse ◽

Child Maltreatment ◽

Physical Abuse ◽

Urban Area ◽

Support Group ◽

Adolescent Girls ◽

Emotional Abuse ◽

Study Participant ◽

Study Participants ◽

Do So

Abstract The study examines the barriers to disclosure of child maltreatment among adolescent girls. Stratified random sampling was done among classes 7 to 12 of government girls’ schools of a semi-urban area of Delhi, and a total of 1060 adolescent girls participated. Almost 33% of victims of physical abuse, 50% of sexual abuse, 30% of emotional abuse, and 40% of neglect did not disclose their experiences to any support group. The most frequent confidante, in almost two-thirds of cases of all forms of abuse was a friend of the study participant. Among the study participants who did not disclose abuse, the most common reason for nondisclosure was a feeling of shame or embarrassment (40%–80% for physical abuse, 55%–80% for sexual abuse, and 55% for emotional abuse). Among the study participants who did not disclose neglect, 70% reported that they did not do so because they had no expectation of help from anyone.

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