One-year follow-up of treatment outcomes and patient opinions of Retraining and Control Therapy (ReACT) for pediatric functional seizures

Stager, Lindsay; Szaflarski, Jerzy P.; Fobian, Aaron D.

doi:10.1016/j.ebr.2021.100503

Cited by 10 publications

(7 citation statements)

References 32 publications

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“…All these clinicians and their teams have contributed to recent advances in theory, best-practice guidelines, and evaluation of treatment outcomes, thereby providing direction for clinicians around the world (see Supplemental Text Box 2, http://links.lww.com/HRP/A210). 10,11,15,20,25,37,40,43,58,59,74,80,81,92,108–128 Through collaborative efforts, these teams have also worked hard to highlight that the pressing need to develop an FND-informed culture of care that takes into account recent advances in our understanding and clinical care of children and adolescents with FND 26 …”

Section: Discussionmentioning

confidence: 99%

Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder

Kozlowska

Chudleigh

Savage

et al. 2023

Harv Rev Psychiatry

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Learning objectives:• Develop and implement treatment plans for children and adolescents with functional neurological disorder (FND) • Outline a plan to increase awareness and standardize the care for patients with FND using evidence-based interventions Abstract: Functional neurological disorder (FND) in children and adolescents involves the biological embedding of lived experience in the body and brain. This embedding culminates in stress-system activation or dysregulation and in aberrant changes in neural network function. In pediatric neurology clinics, FND represents up to one-fifth of patients. Current research shows good outcomes with prompt diagnosis and treatment using a biopsychosocial, stepped-care approach. At present, however-and worldwide-FND services are scarce, the result of long-standing stigma and ingrained belief that patients with FND do not suffer from a real ("organic") disorder and that they therefore do not require, or even deserve, treatment. Since 1994, the Mind-Body Program for children and adolescents with FND at The Children's Hospital at Westmead in Sydney, Australia-run by a consultation-liaison team-has delivered inpatient care to hundreds of patients with FND and outpatient care to hundreds of others. For less-disabled patients, the program enables community-based clinicians to implement biopsychosocial interventions locally by providing a positive diagnosis (by a neurologist or pediatrician), a biopsychosocial assessment and formulation (by clinicians from the consultation-liaison team), a physical therapy assessment, and clinical support (from the consultation-liaison team and the physiotherapist). In this Perspective we describe the elements of a biopsychosocial mind-body program intervention capable of providing, as needed, effective treatment to children and adolescents with FND. Our aim is to communicate to clinicians and institutions around the world what is needed to establish effective community treatment programs, as well as hospital inpatient and outpatient interventions, in their own health care settings.

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Section: Discussionmentioning

confidence: 99%

Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder

Kozlowska

Chudleigh

Savage

et al. 2023

Harv Rev Psychiatry

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“…Eight of the 14 participants had no events in the 30 days prior to the 1‐year follow‐up. This suggests that the treatment leads to long‐term reductions of PNES for at least some participants 104 . Most other studies focusing on interventions and management included multidisciplinary management and/or referral to a psychologist or psychiatrist.…”

Section: Discussionmentioning

confidence: 99%

Scoping review and expert‐based consensus recommendations for assessment and management of psychogenic non‐epileptic (functional) seizures (PNES) in children: A report from the Pediatric Psychiatric Issues Task Force of the International League Against Epilepsy

Reilly,

Jette,

Johnson

et al. 2023

Epilepsia

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Limited guidance exists regarding the assessment and management of psychogenic non‐epileptic seizures (PNES) in children. Our aim was to develop consensus‐based recommendations to fill this gap. The members of the International League Against Epilepsy (ILAE) Task Force on Pediatric Psychiatric Issues conducted a scoping review adhering to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐SR) standards. This was supplemented with a Delphi process sent to pediatric PNES experts. Consensus was defined as ≥80% agreement. The systematic search identified 77 studies, the majority (55%) of which were retrospective (only one randomized clinical trial). The primary means of PNES identification was video electroencephalography (vEEG) in 84% of studies. Better outcome was associated with access to counseling/psychological intervention. Children with PNES have more frequent psychiatric disorders than controls. The Delphi resulted in 22 recommendations: Assessment—There was consensus on the importance of (1) taking a comprehensive developmental history; (2) obtaining a description of the events; (3) asking about potential stressors; (4) the need to use vEEG if available parent, self, and school reports and video recordings can contribute to a “probable” diagnosis; and (5) that invasive provocation techniques or deceit should not be employed. Management—There was consensus about the (1) need for a professional with expertise in epilepsy to remain involved for a period after PNES diagnosis; (2) provision of appropriate educational materials to the child and caregivers; and (3) that the decision on treatment modality for PNES in children should consider the child's age, cognitive ability, and family factors. Comorbidities—There was consensus that all children with PNES should be screened for mental health and neurodevelopmental difficulties. Recommendations to facilitate the assessment and management of PNES in children were developed. Future directions to fill knowledge gaps were proposed.

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“…This suggests that physically based therapy can be effective for FS, and FS symptoms can be physically retrained. 34,35 https://doi.org/10.2147/NDT.S383552…”

Section: Discussionmentioning

confidence: 99%

Management of Functional Seizures and Functional Movement Disorder: A Cross-Sectional Comparative Study

Pasquale¹,

Teive²,

Heyde³

et al. 2022

NDT

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Introduction Functional neurological disorders (FND) are conditions that cause to alterations in nervous system functions. They are disabling and impair the quality of life of patients but that are potentially reversible provided they have specific management. Functional seizures (FS) and functional movement disorder (FMD) are among the most common subtypes. Studies suggest a strong overlap between FS and FMD; however, there are still no cross-sectional studies that compare the management between these two conditions. Thus, our focus was to carry out a research that compares how these two subtypes of FND are being managed, in addition to assessing rates of understanding and acceptance of a diagnosis of FND. Methods It is a cross-sectional study with data collected from medical records and interviews with two patients’ groups (FS and FMD) treated from a FND clinic of the public health system of Brazil. Results From 105 medical records of patients with FND analyzed, 60 participants were eligible and agreed to participate in this research, being FS (n = 31) and FMD (n = 29). Statistically significant differences (p < 0.05) were found in the use of antiseizure (FS > FMD), opioids (FMD > FS), multi-professional follow-up (FMD > FS) and rates of understanding and acceptance of an FND diagnosis (FMD > FS). Similarities were found in sociodemographic profiles, medical follow-up, psychiatric comorbidities and use of antidepressants, anxiolytics, antipsychotics and mood stabilizers between two conditions. Conclusion More similarities than differences in management were found between FS and FMD. Similarities may be related to overlaps in sociodemographic and clinical characteristics between the two groups. Differences may be related to specific issues of each patient and condition. Regardless of the group, patients who perform psychotherapeutic follow-up have higher rates of understanding and acceptance of an FND diagnosis.

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One-year follow-up of treatment outcomes and patient opinions of Retraining and Control Therapy (ReACT) for pediatric functional seizures

Cited by 10 publications

References 32 publications

Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder

Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder

Scoping review and expert‐based consensus recommendations for assessment and management of psychogenic non‐epileptic (functional) seizures (PNES) in children: A report from the Pediatric Psychiatric Issues Task Force of the International League Against Epilepsy

Management of Functional Seizures and Functional Movement Disorder: A Cross-Sectional Comparative Study

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