Nonepileptic seizures – subjective phenomena

Reuber, Markus; Rawlings, Gregg H.

doi:10.1016/b978-0-12-801772-2.00025-4

Cited by 24 publications

(17 citation statements)

References 88 publications

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“…22 Surveys of other healthcare professionals report similar findings, although to lesser degree. 1 Patients with functional seizures are more likely than those with epilepsy to consider their problem "somatic" rather than "psychological," and to deny significant nonhealth stresses in their lives. 23 A similar level of doubt about the involuntary nature of functional symptoms was highlighted in a questionnaire-based study of 68 specialist neuroscience nurses.…”

Section: Discussionmentioning

confidence: 99%

“…In reality <50% of patients report feeling stressed before functional seizures, and in many cases patients do not identify obvious triggers. 1 Patients with functional seizures are more likely than those with epilepsy to consider their problem "somatic" rather than "psychological," and to deny significant nonhealth stresses in their lives. 26 The information provided by GPs to their patients is a product of their perception and knowledge of functional seizures.…”

Section: Discussionmentioning

confidence: 99%

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Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

et al. 2018

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Summary Objective Functional seizures are a common functional neurologic disorder. Given their chronic nature, and the biopsychosocial factors involved in their etiology, general practitioners (GPs) play a crucial role in the care of these patients. However, little is known about the attitudes of GPs toward, and knowledge of, functional seizures. Methods The Atkinson Morley Regional Neuroscience Centre in London provides a comprehensive service to patients with functional seizures. As part of a service evaluation we conducted an online survey among local GPs over a 1‐month period assessing their attitudes toward, and knowledge of, functional seizures. Results One hundred twenty of 974 surveyed GPs replied to the survey (12.3%). Approximately 75% of GPs readily use the term “pseudoseizures,” and over 50% were not sure or did not think that functional seizures were involuntary. Nearly 30% believed, or were unsure as to whether, functional seizures occur only when patients are stressed. Despite approximately 50% of GPs expressing interest in getting involved in the management of these patients, a similar proportion do not feel confident in dealing with queries from patients with functional seizures. Although most GPs felt that neurology and psychiatry should be the primary caregivers in the diagnosis and management, respectively, of functional seizures, 50% were also of the opinion that neurology should be involved in the management of these patients. Significance This survey highlights the attitudes of, and descriptive terms used by, GPs toward patients with functional seizures. Our findings suggest a need for better and clearer provision of information to GPs about this condition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

et al. 2018

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“…Psychogenic nonepileptic seizures (PNES) are episodes of impaired self‐control associated with a range of motor, sensory, and mental manifestations . Although PNES superficially resemble epileptic seizures, they are not caused by epileptiform activity.…”

Section: Introductionmentioning

confidence: 99%

Health care practitioners’ perceptions of psychogenic nonepileptic seizures: A systematic review of qualitative and quantitative studies

Rawlings

Reuber

2018

Epilepsia

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A recent systematic synthesis of qualitative research demonstrated that patients with psychogenic nonepileptic seizures (PNES) often experience unsatisfactory encounters with health care practitioners (HCPs). It is important to understand such interactions from the perspective of those responsible for delivering care. This systematic review aimed to examine the attitudes and perceptions of HCPs toward PNES. A systematic search of 3 databases (Web of Science, PubMed, and CINAHL) was conducted in November 2017. Studies from around the world published after 1997 using qualitative or quantitative methodologies were reviewed. An interpretative stance was taken to analyze the data utilizing a grounded theory approach. The quality of studies included was assessed using the Mixed Methods Appraisal Tool. Overall, 30 separate studies capturing the views of at least 3900 professionals were included. Five concepts emerged from the analysis: (1) HCPs' responses demonstrated uncertainty about many aspects of PNES, including diagnosis and treatment; (2) HCPs understood PNES in dualistic terms, perceiving the condition as largely associated with psychological factors; (3) Patients with PNES were considered challenging and frustrating; (4) HCPs held mixed or contested views about who is responsible for treating patients with PNES; and (5) PNES was viewed as less severe or disabling than epilepsy and associated with a greater degree of volition. Although some HCPs have an excellent understanding of PNES, the views of many give rise to concern. The number of qualitative studies that directly ask HCPs about their perceptions of PNES is limited. Moreover, some professional groups (ie, mental health specialists) are underrepresented in current research. This study reveals a demand for additional training. However, effort is needed also to change the attitudes of some practitioners toward PNES.

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“…The difficulty of effectively managing PNES was reflected in our survey responses, illustrating the challenges faced by clinicians. In Canada and around the world, these include overcoming both public and professional stigmatization of the disorder, absence of popular awareness, and the lack of standard practices being followed by specialists [23,24]. In addition, our survey revealed knowledge gaps among epileptologists about the mode of action of psychological treatmentcurrently the treatment of choice for PNES.…”

Section: Discussionmentioning

confidence: 95%

Experience of psychogenic nonepileptic seizures in the Canadian league against epilepsy: A survey describing current practices by neurologists and epileptologists

Carter

Denton

Ladino

et al. 2018

Seizure

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Nonepileptic seizures – subjective phenomena

Cited by 24 publications

References 88 publications

Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

Health care practitioners’ perceptions of psychogenic nonepileptic seizures: A systematic review of qualitative and quantitative studies

Experience of psychogenic nonepileptic seizures in the Canadian league against epilepsy: A survey describing current practices by neurologists and epileptologists

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