A Therapeutic Approach to Psychogenic Nonepileptic Seizures

Haykal, M. Ayman; Smith, Brien

doi:10.1007/s11940-015-0371-4

Cited by 9 publications

(2 citation statements)

References 59 publications

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“…[13, 14] In addition, correctly categorizing PNES as an SSD rather than a neurologic disease permits referral for appropriate PNES treatment with cognitive behavioral therapy and psychiatric medication for comorbid psychiatric disease if appropriate. [15] Accordingly, identifying positive predictive tests to aid in diagnosis is essential.…”

Section: Discussionmentioning

confidence: 99%

Number of patient-reported allergies helps distinguish epilepsy from psychogenic nonepileptic seizures

Robbins

Larimer

Bourgeois

et al. 2016

Epilepsy & Behavior

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Summary Psychogenic non-epileptic seizures (PNES) are relatively common, accounting for 5–40% of visits to tertiary epilepsy centers. Inpatient video electroencephalogram (vEEG) monitoring is the gold standard for diagnosis, but additional positive predictive tools are necessary given vEEG’s relatively scarce availability. In this study we investigate if the number of patient-reported allergies distinguishes between PNES and epilepsy. Excessive allergy-reporting, like PNES, may reflect somatization. Using the electronic medical record, ICD-9 codes, and text-identification algorithms to search EEG reports, we identified 905 cases of confirmed PNES and 5187 controls with epilepsy but no PNES. Patients with PNES averaged more self-reported allergies than patients with epilepsy alone (1.93 vs. 1.00, p<0.001). Compared to those with no allergies, each additional allergy linearly increased the percentage of patients with PNES by 2.98% (R2=0.71) such that with ≥ 12 allergies, 12/28 patients (42.8%) had PNES compared to 349/3368 (11.6%) of the population with no allergies (odds ratio = 6.49). This relationship remained unchanged with logistic regression analysis. We conclude that long allergy lists may help identify patients with PNES. We hypothesize that a tendency to inaccurately self-report allergies reflects a maladaptive externalization of psychologic distress, and that a similar mechanism may be responsible for PNES in some patients with somatic symptom disorder.

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Section: Discussionmentioning

confidence: 99%

Number of patient-reported allergies helps distinguish epilepsy from psychogenic nonepileptic seizures

Robbins

Larimer

Bourgeois

et al. 2016

Epilepsy & Behavior

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“…Currently, there is limited evidence for the use of STPP for the specific FND presentation of DS (Haykal & Smith, 2015;Phakey et al, 2021). Previous literature shows eight studies (Barry et al, 2008;De Oliveira et al, 2016;Hubschmid et al, 2015;Metin et al, 2013;Major et al, 2010;Russell, Turner & Yates, 2017;Russell et al, 2016; specifically reporting the use of STPP for DS.…”

Section: Empirical Evidence Of Istdpmentioning

confidence: 99%

Three sessions of intensive short-term dynamic psychotherapy (ISTDP) for patients with dissociative seizures: a pilot study

Castillo

Beton

Coman

et al. 2022

Psychoanalytic Psychotherapy

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Intensive Short Term Psychodynamic Therapy (ISTDP) has demonstrated promising evidence for the treatment of several Functional Neurological Disorders (FND) including dissociative seizures. However, its implementation in secondary mental health and specialist services within the English National Health Service (NHS) is scarce. The aim of this pilot study was to explore the estimates of the therapeutic effects of a 3-session course of this treatment as well as establish safety and acceptability for a complex patient group. Method: The study followed a mixed methods case series design and recruited 18 patients from secondary adult mental health care and specialist neurology services. Participants completed self-report outcome measures at the start, at the end and 1-month following the completion of therapy. Three open ended questions examined their therapy experiences qualitatively and these were analysed through thematic analysis. Results: All participants who started the treatment (N=17) completed the intervention and attendance rates were very high (95%). No serious adverse effects were observed, and the CORE-OM and BSI showed improvements both at the end of the treatment and at follow-up. Healthcare utilisation was also reduced including acute medications, A&E attendances, and crisis line usage. Conclusions: The results provide preliminary support for the safe use of ISTDP in this complex group of participants but further evidence from controlled and randomized studies is warranted.

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Psychogenic Nonepileptic Seizures

Gale¹,

Dodrill²

2016

Encyclopedia of Clinical Neuropsychology

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A Therapeutic Approach to Psychogenic Nonepileptic Seizures

Cited by 9 publications

References 59 publications

Number of patient-reported allergies helps distinguish epilepsy from psychogenic nonepileptic seizures

Number of patient-reported allergies helps distinguish epilepsy from psychogenic nonepileptic seizures

Three sessions of intensive short-term dynamic psychotherapy (ISTDP) for patients with dissociative seizures: a pilot study

Psychogenic Nonepileptic Seizures

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