First do no harm: Preventing harm and optimizing care in psychogenic nonepileptic seizures

A journey into the unknown: An ethnographic examination of drug-resistant epilepsy treatment and management in the United States

“…Accurate biometrics from machine learning and artificial intelligence analyses of electroencephalography data, for example, have the potential to provide rapid clinical insights on surgical candidacy, seizure forecasting, and rapid acknowledgment of medication efficacy and failure [30,31]. Advances in remote long-term video monitoring facilitated by family members or caregivers for identification of nonepileptic seizures could protect patients from undergoing unnecessary treatments [32]. Such technological advances have the potential to create a future paradigm shift by introducing novel epilepsy treatment and management pipelines throughout a patient's journey [33][34][35] (Fig.…”

Neurology specialists’ visual interpretation of psychogenic nonepileptic seizures: Contemplating their etiology and existing challenges

“…Physicians indicate to lack clear information that they could communicate to their patients or feeling pressure to provide a somatic diagnosis. If a successful clarification of the nature of the disorder is possible, from the viewpoint of a neurologist, further steps could be discussing a treatment plan and referring the patient to a mental health specialist with a subsequent professional presence throughout the treatment process [10,35]. Here emerges the fact that the patient's willingness and ability to take part in future procedures is essential.…”

“…Because PNES mimic epileptic seizures (and are often misdiagnosed as those) but have such a complex biopsychosocial etiology, it makes them a great challenge for the healthcare providers (HCPs) involved [9]. Further considering that the existing comorbidities might be of both neurological (migraine, epilepsy) and psychiatric (mood disorders, borderline personality disorder) nature, it becomes clear that patients with PNES require a multidisciplinary approach with overlapping neurologist, psychiatrist and primary care physician roles [7,10]. Data from questionnaires and interviews with HCPs suggest that issues like uncertainty, lack of understanding or difficulties in sharing responsibility might often undermine effective care of PNES [11,12].…”