A comprehensive neuropsychological profile of women with psychogenic nonepileptic seizures

Strutt, Adriana M.; Hill, Stacy W.; Scott, Bonnie M.; Uber-Zak, Lori; Fogel, Travis G.

doi:10.1016/j.yebeh.2010.10.004

Cited by 51 publications

(32 citation statements)

References 42 publications

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“…However, in our study as in others [12,[39][40][41], the percentage of patients who achieved higher education is low, ranging from 12% [39] to 15% [12]. Most patients had only primary education (low and middle school) with less than 8 to 13 years of formal education [40,41], which is similar to that observed in patients with epilepsy [40].…”

Section: Discussionsupporting

confidence: 82%

Psychogenic non-epileptic seizures at a tertiary care center in Brazil

Alessi

Valente

2013

Epilepsy & Behavior

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Although psychogenic non-epileptic seizures (PNES) are a worldwide phenomenon, most of our knowledge addressing clinical characteristics is based on studies conducted in the USA, Europe, and Australia. There are scarce data about PNES in South American countries. This study provided a detailed analysis of the demographic, clinical, and psychosocial characteristics of 102 Brazilian patients with PNES. Seventy-eight patients (76.4%) were female with mean age of 35.27 years. Mean age at onset was 27.85 years; mean time to diagnosis was 7.89 years; 87.25% lived with their families; 56.89% were single; and only 33 (39.75%) worked on a regular basis. Depression was diagnosed in 48.03%. Thirty-three patients misdiagnosed as having epilepsy were using antiepileptic drugs. Stress factors were identified in 57.84%. This is the first Brazilian study that involves a large sample of patients with video-EEG-documented PNES and corroborates the idea that PNES are a worldwide phenomenon sharing several similarities, despite cultural and socioeconomic differences.

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Section: Discussionsupporting

confidence: 82%

Psychogenic non-epileptic seizures at a tertiary care center in Brazil

Alessi

Valente

2013

Epilepsy & Behavior

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“…There is some neuropsychological and experimental evidence for impaired attentional-executive functioning in patients with PNES and symptoms such as memory and concentration problems are commonly reported by this group (e.g., Bakvis, Spinhoven, Putman, Zitman, & Roelofs, 2010;Pouretemad et al, 1998;Strutt, Hill, Scott, Uber-Zak, & Fogel, 2011;Willment, Hill, Baslet, & Loring, 2015). Roelofs, van Galen, Eling, Keijsers, and Hoogduin (2003) also found evidence of an attentional deficit in patients with conversion paresis, which would involve similar mechanisms to PNES in the current model.…”

Section: High Level Processing Dysfunctionsupporting

confidence: 53%

Towards an integrative theory of psychogenic non-epileptic seizures (PNES)

Brown

Reuber

2016

Clinical Psychology Review

217

208

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Current models of PNES can account for some but not all of the available data.• Automatic activation of seizure representations in memory may be a unifying process.• Suppression of arousal and distress are typical maintaining factors for PNES.• Inhibitory dysfunction, often arising from chronic stress, is a key vulnerability. • Trauma exposure is common but neither necessary nor sufficient for PNES to occur. a b s t r a c tPsychogenic Nonepileptic Seizures (PNES) superficially resemble epileptic seizures but are thought to have a psychological rather than epileptic basis. Patients with PNES vary widely in terms of background, personality profiles, comorbidities, response to treatment and outcomes. Previous accounts interpreting these seizures as the activation of dissociated material, a physical manifestation of emotional distress, hard-wired reflex responses, or learned behaviours cannot explain key features of the phenomenon. Drawing on a brief review of the literature on etiology, correlates and phenomenology of PNES, this paper integrates existing approaches and data within a novel explanatory framework that applies to all PNES patients with subjectively involuntary seizures. Following the Integrative Cognitive Model of medically unexplained symptoms, we suggest that the central feature of all PNES is the automatic activation of a mental representation of seizures (the "seizure scaffold") in the context of a high level inhibitory processing dysfunction. This often arises in response to elevated autonomic arousal, and may disrupt the individual's awareness of distressing material, but can become divorced from abnormal autonomic and emotional activity. This model accounts both for existing findings and the heterogeneity of patients with PNES, whilst leading to a number of novel hypotheses against which it can be evaluated.

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“…However, we did find abnormalities in FC in highly dissociative patients with PNES based on seed regions obtained by the Stroop task. Previous studies in patients with PNES did indicate only a modest working memory deficiency 41. We propose that the PNES pathology affects the neurobiology of executive control, which underlies dissociation, rather than the networks involved in memory processes.…”

Section: Discussionmentioning

confidence: 51%