New insights into psychogenic nonepileptic seizures 2011–2014

Wiseman, Hannah; Reuber, Markus

doi:10.1016/j.seizure.2015.03.008

Cited by 33 publications

(20 citation statements)

References 55 publications

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“…In the field of PNES this goal currently seems beyond reach, but recent progress in the neurobiological and psychological underpinnings of PNES will hopefully allow us to better tailor treatments to individual patients in this heterogeneous patient population. 14,67 Our deepening understanding of this condition hopefully also means that agencies that fund research and service developments will recognize the importance of this disabling disorder and that stigma will be reduced. 68 Ensuring that patients are well informed and empowered This is possibly the largest challenge, but one that must be achieved for change to occur.…”

Section: The Individualization Of Care-a Blueprint For Conversion/dismentioning

confidence: 99%

PNES around the world: Where we are now and how we can close the diagnosis and treatment gaps—an ILAE PNES Task Force report

et al. 2017

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SummaryAn international consensus clinical practice statement issued in 2011 ranked psychogenic nonepileptic seizures (PNES) among the top three neuropsychiatric problems. An ILAE PNES Task Force was founded and initially charged with summarizing the current state of the art in terms of diagnosis and treatment, resulting in two publications. The first described different levels of diagnostic certainty. The second summarized current knowledge of management approaches. The present paper summarizes an international workshop of the ILAE PNES Task Force that focused on the current understanding and management of PNES around the world. We initially provide a knowledge update about the etiology, epidemiology, and prognosis of PNES—in adults and in special patient groups, such as children, older adults, and those with intellectual disability. We then explore clinical management pathways and obstacles to optimal care for this disorder around the world by focusing on a number of countries with different cultural backgrounds and at very different stages of social and economic development (United Kingdom, U.S.A., Zambia, Georgia, China, and Japan). Although evidence‐based methods for the diagnosis and treatment of PNES have now been described, and much is known about the biopsychosocial underpinnings of this disorder, this paper describes gaps in care (not only in less developed countries) that result in patients with PNES not having adequate access to healthcare provisions. A range of challenges requiring solutions tailored to different healthcare systems emerges. Continued attention to PNES by the ILAE and other national and international neurologic, psychiatric, and health organizations, along with ongoing international collaboration, should ensure that patients with PNES do not lose out as healthcare services evolve around the world.

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Section: The Individualization Of Care-a Blueprint For Conversion/dismentioning

confidence: 99%

PNES around the world: Where we are now and how we can close the diagnosis and treatment gaps—an ILAE PNES Task Force report

et al. 2017

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“…Although a clear communication of the diagnosis and psychological treatment such as psychoeducation and psychotherapy are important to improve seizure status, outcome is generally poor. Approximately two‐thirds of the patients still have PNES years after the diagnosis was communicated.…”

Section: Introductionmentioning

confidence: 99%

“…somatoform symptoms, dissociative or personality disorders, a history of abuse or other traumatizing events, and posttraumatic stress disorder. [3][4][5] Although a clear communication of the diagnosis and psychological treatment such as psychoeducation and psychotherapy are important to improve seizure status, 6 outcome is generally poor. Approximately two-thirds of the patients still have PNES years after the diagnosis was communicated.…”

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confidence: 99%

Psychological long‐term outcome in patients with psychogenic nonepileptic seizures

et al. 2019

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Summary Objective To examine the long‐term outcome of psychological status, personality, and health‐related quality of life (HRQoL) in patients with psychogenic nonepileptic seizures (PNES) and to define predictors of favorable outcome of cessation of PNES. Method Patients diagnosed with PNES during video–electroencephalography (EEG) monitoring at the Erlangen Epilepsy Center were contacted 1‐16 years after communicating the diagnosis. Follow‐up information from each participant was obtained by interview (PNES outcome) and by self‐reported questionnaires of psychological symptoms (Beck Depression Inventory‐II, Symptom Checklist‐90‐Standard, Dissociative Symptoms questionnaire), personality traits (Freiburg Personality Inventory‐Revised), and HRQoL (36‐Item Short Form Health Survey). Results Fifty‐two patients participated in the study (mean age ± standard deviation [SD] 40.5 ± 14.0 years; 75% female, follow‐up: 5.3 ± 4.2 years). Nineteen patients (37%) were free of PNES for the past 12 months. Patients with persisting PNES were older at disease onset (32.9 vs 22.3 years, P < 0.01) and diagnosis (40.5 vs 27.2 years, P < 0.001), and showed worse psychological functioning, lower extraversion and life satisfaction, and higher inhibitedness and worse HRQoL than PNES‐free patients. Patients with cessation of PNES were within the normal range in all dimensions. Cessation of PNES was best predicted by younger age at PNES onset and higher extraversion. Significance Outcome of PNES is poor, psychopathology is high, and HRQoL is low in patients with persistent PNES but may normalize with PNES cessation. High introversion and older age at PNES onset are risk factors for persistent PNES.

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“…Psychogenic nonepileptic seizure disorders (PNES) comprise paroxysms that superficially resemble those seen in epilepsy but are not associated with the abnormal electrical activity in the brain that characterizes epilepsy. Most PNES are understood to occur as a manifestation of distress or via attentional and belief‐driven processes . Both types of seizure disorders may remit but become a chronic problem in many cases …”

Section: Introductionmentioning

confidence: 99%

The frequency and management of seizures during psychological treatment among patients with psychogenic nonepileptic seizures and epilepsy

et al. 2018

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In-session seizures do occur and are much more common in patients with PNES than in those with epilepsy. Seizures rarely caused major disruption to psychological treatment, and could almost invariably be managed by the treating therapist without help from additional medical staff. Nonetheless, this research suggests that psychological therapy providers should anticipate the occurrence of in-session seizures and have safe management plans in place. The greater frequency of in-session seizures in PNES may add to our understanding of the mechanisms triggering these seizures.

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New insights into psychogenic nonepileptic seizures 2011–2014

Cited by 33 publications

References 55 publications

PNES around the world: Where we are now and how we can close the diagnosis and treatment gaps—an ILAE PNES Task Force report

PNES around the world: Where we are now and how we can close the diagnosis and treatment gaps—an ILAE PNES Task Force report

Psychological long‐term outcome in patients with psychogenic nonepileptic seizures

The frequency and management of seizures during psychological treatment among patients with psychogenic nonepileptic seizures and epilepsy

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