Psychogenic Nonepileptic Seizures (PNES) in the Setting of Trauma and Schizophrenia

Abstract

Psychogenic nonepileptic seizures (PNES) are nonepileptic events characterized by seizure-like manifestations without abnormal electrical activity in the brain. Our case report illustrates the diagnostic journey of a young female with a history of schizophrenia and childhood trauma who had an initial misdiagnosis of epilepsy. The etiology of PNES is complex. Major depressive disorder and generalized anxiety disorder are common comorbid conditions in these patients. Additionally, previous trauma has been linked as a predisposing factor for the development of PNES. Psychotic disorders, specifically schizophrenia, have only recently been associated with PNES. We explore this relationship in depth, while also underscoring the diagnostic and treatment challenges of PNES that clinicians must remain aware of.

Understanding Mal de Debarquement syndrome (MdDS), persistent postural perceptual dizziness (3PD) and somatoform disorders: and the role of vestibular rehabilitation therapy (VRT)

“…VRT has been well-recognized as an invaluable non-medical management tool for the full continuum of conditions with subjective complaints of dizziness and motion intolerance. 9 Patients presenting with MdDS, 3PD or even Motor Conversion diagnoses pose a different set of challenges and require a different approach and set of protocols. Likewise, while all patients do better with coaching and encouragement, the addition of Cognitive Behavioral Therapy (CBT) in combination with vestibular rehabilitation has shown to be particularly important for this patient population.…”