Newly presenting psychogenic nonepileptic seizures: Incidence, population characteristics, and early outcome from a prospective audit of a first seizure clinic

Duncan, Roderick; Razvi, Saif; Mulhern, Sharon

doi:10.1016/j.yebeh.2010.10.022

Cited by 189 publications

(158 citation statements)

References 22 publications

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“…[18][19][20] For a subset of patients, this explanation may be therapeutic. 19,21,22 It may also lead to reduction in healthcare use. 23 It was therefore encouraging that so many practitioners appeared to see it as their responsibility to deliver the PNES diagnosis face to face.…”

Section: Communicating the Pnes Diagnosismentioning

confidence: 99%

Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force

Hingray¹,

et al. 2017

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SummaryObjective: Studies from a small number of countries suggest that patients with psychogenic nonepileptic seizures (PNES) have limited access to diagnostic and treatment services. The PNES Task Force of the International League Against Epilepsy (ILAE) carried out 2 surveys to explore the diagnosis and treatment of PNES around the world. Methods: A short survey (8 questions) was sent to all 114 chapters of the ILAE.A longer survey (36 questions) was completed by healthcare professionals who see patients with seizures. Questions were separated into 5 sections: professional role, diagnostic methods, management, etiology, and access to health care. Results: Responses were received from 63 different countries. The short survey was completed by 48 ILAE chapters, and the long survey by 1098 health professionals from 28 countries. PNES were recognized as a diagnostic and therapeutic problem in all countries. Trauma and mental health issues were most commonly recognized as etiologic factors. There was a clear relationship between income and access to diagnostic tests and expertise. Psychological therapy was most commonly considered the treatment of choice. Although financial difficulties were the most commonly reported problem with service access in low-income countries, in

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Section: Communicating the Pnes Diagnosismentioning

confidence: 99%

Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force

Hingray¹,

et al. 2017

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“…100 000 főre eső incidenciája 1,4-4,9 eset évente, de a diagnosztikai nehézségek miatt a valós arány ennél minden bizonnyal magasabb [10,11]. Benbadis és Allen-Hauser becslései szerint a 100 000 főre eső prevalencia 2-33 eset évente [12].…”

Section: Epidemiológiaunclassified

Pszichogén nem epilepsziás rosszullétek a klinikai gyakorlatban

Szita

Hidasi

2016

Orvosi Hetilap

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A pszichogén, nem epilepsziás roham a pszichiátria és neurológia határterületén lévő, nehezen behatárolható tünet-együttes, amely tünetmintázatában hasonlít az epilepsziára, de azt nem epilepsziás aktivitás váltja ki. Jellemzően fiatal felnőttkorban alakul ki, a betegek körében a nők aránya jóval magasabb. A pszichogén, nem epilepsziás roham diagnosztikája elsősorban video-elektroencefalográfiás vizsgálattal történhet, amely az esetek 90%-ában a helyes diagnózis megállapításához vezethet. A kórképet mégis gyakran diagnosztizálják tévesen epilepsziának, és kezelik évekig ennek megfelelően, ami a betegekre és az egészségügyi ellátórendszerre egyaránt nagy terhet ró. A kórkép etiológiájában -az anamnézisben szereplő traumatikus életesemények gyakorisága miatt -kiemelt szerepet tulajdonítanak a pszichológiai faktoroknak. Emellett a pszichogén nem epilepsziás roham kialakulásában neurobiológiai tényezők is köz-rejátszanak, amelyre a betegek egy részénél talált kognitív, strukturális és funkcionális agyi eltérések utalnak. A kezelés pszichoszociális -elsősorban kognitív viselkedésterápiás -intervenciókat és kiegészítő farmakoterápiát foglal magába. A tanulmányban a szerzők a pszichogén nem epilepsziás roham tünettanával, diagnosztikájával, etiológiájával és kezelésével kapcsolatos irodalmat és az újabb kutatási eredményeket tekintik át. Orv. Hetil., 2016, 157(20), 767-775. Kulcsszavak: pszichogén nem epilepsziás roham, video-EEG, szemiológia, etiológia, kezelés Psychogenic nonepileptic seizures: overview and implications for practicePsychogenic 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. Rövidítések CBT = kognitív viselkedésterápia; EMG = elektromiográfia; MMPI = Minnesota Multiphasic Personality Inventory; PNER = pszichogén nem epilepsziás roham; PTSD = poszttraumás stressz zavar; SISCOM = Subtraction Ictal SPECT Co-registered to MRI; SSRI = (selective serotonin reuptake inhibitor) szelektív szerotonin-visszavétel...

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“…Three studies have estimated the annual incidence of PNES at between 1.4 and 6.7 episodes per 100 000 people (Sigurdardottir 1998;Szaflarski 2000;Duncan 2011). These studies are likely to have underestimated the true incidence of PNES because they only counted patients diagnosed on the basis of video-EEG evidence.…”

Section: Epidemiologymentioning

confidence: 99%

“…Even when seizures persist, there is evidence that a confident diag nosis of PNES results in a significant reduction of healthcare utilisation by patients (Hall-Patch 2010;Duncan 2011). Giving patients a booklet about PNES or referring them to a website (e.g.…”

Section: Communicating the Diagnosismentioning

confidence: 99%

Psychogenic non-epileptic seizures: aetiology, diagnosis and management

Oto¹,

Reuber²

2014

Adv. psychiatr. treat

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SummaryPsychogenic non-epileptic seizures (PNES) have a significant impact on most patients in terms of distress, disability, loss of income and iatrogenic harm. Three-quarters of patients with PNES are initially misdiagnosed and treated for epilepsy. Misdiagnosis exposes patients to multiple iatrogenic harms and prevents them from accessing psychological treatment. In most cases, the patient's history (and witness accounts) should alert clinicians to the likely diagnosis of PNES. Since this diagnosis may be resisted by patients and may involve ‘un-diagnosing’ epilepsy, video-electroencephalogram recording of typical seizures is often helpful. The underlying causes of PNES are diverse: a model combining predisposing, precipitating and perpetuating factors is a useful way of conceptualising their aetiology. The initial step of treatment should be to limit iatrogenic harm. There is some evidence for the effectiveness of psychotherapy.

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Newly presenting psychogenic nonepileptic seizures: Incidence, population characteristics, and early outcome from a prospective audit of a first seizure clinic

Cited by 189 publications

References 22 publications

Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force

Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force

Pszichogén nem epilepsziás rosszullétek a klinikai gyakorlatban

Psychogenic non-epileptic seizures: aetiology, diagnosis and management

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