Psychogenic seizures: clinical features and psychological analysis

Abubakr, Abuhuziefa; Kablinger, Anita S.; Caldito, Gloria

doi:10.1016/s1525-5050(03)00082-9

Cited by 100 publications

(65 citation statements)

References 24 publications

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“…50 Comparative studies between patients with PNES and with epilepsy yielded contrasting results in this regard. Some studies found no differences, 51 whereas other found increased Axis I disorders in PNES patients. 52 In one study conducted on 42 patients with documented PMD, a structured interview disclosed a coexisting psychiatric disorder in almost all of them: 19.1% had major depression, 38.2% anxiety disorders, 11.9% comorbid major depression and anxiety disorders, and 45% personality disorders.…”

Section: Chronic Painmentioning

confidence: 96%

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Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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Purpose of review: Neurologic symptoms due to a psychogenic cause are frequently seen in clinical practice. Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are among the most common psychogenic neurologic disorders. PNES and PMD are usually investigated and managed separately by different neurology subspecialists. We review the main epidemiologic and clinical features of both PNES and PMD, aiming to highlight their similarities and differences and to see whether a common framework for these disorders exists. Recent findings:Data from the literature show that there is a profound overlap between PNES and PMD, which would argue for a larger unifying pathophysiology with variable phenotypic manifestations. Summary: Collaborative and integrated research among epileptologists, movement disorders experts, psychiatrists, psychologists, and physiotherapists may increase our collective knowledge about the pathophysiologic mechanisms of PNES and PMD and therefore improve outcomes for these patients. Neurol Clin Pract 2016;6:138-149 N eurologic symptoms due to a functional or psychogenic cause are common in clinical practice, accounting for up to 16% of patients presenting to neurology outpatient clinics, depending on the clinical definitions and methodology used for case ascertainment.1,2 The yearly costs of patients with medically unexplained symptoms in the United States have been estimated at approximately $256 billion per year.3 Despite their prevalence and associated economic and social burden, appropriate treatments for these disorders are an unmet need. This may reflect the absence of research interest and lack of discourse between neurology and psychiatry regarding these patients. Notably, although approximately 50% of the patients with somatoform disorders are identified by neurologists at the time of first contact, only 1.5% are referred to a psychiatrist or a psychologist.

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Section: Chronic Painmentioning

confidence: 96%

“…Third decade of life in the majority of patients 2,51 Between the third and the fifth decade of life in the majority of patients 6,7 Risk factors Sexual, emotional, physical abuse Up to 31% …”

Section: Age At Onsetmentioning

confidence: 99%

Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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“…Rosenblum (2000) reviewed case studies and literature exploring links between a history of sexual abuse in childhood and subsequent development of PNES in women and concluded that PNES express their rage, fear and helplessness. His work was followed by that of Abubakr, Kablinger, and Caldito (2003), who analysed clinical features of 23 female patients with PNES and found that more than half of those who had motor manifestations had a history of sexual and physical abuse. Prigatano, Stonnington, and Fisher (2002) also found that sexual abuse in childhood and dissociative phenomena were common among PNES patients referred for group psychotherapy.…”

Section: Review Of Literaturementioning

confidence: 99%

Eye movement desensitization and reprocessing in the psychological treatment of trauma‐based psychogenic non‐epileptic seizures

Kelley

Benbadis

2007

Clin Psychology and Psychoth

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Little is known about the types of mental health treatment that are most effective for psychogenic non-epileptic seizure (PNES) patients who have high rates of comorbid post-traumatic stress disorder (PTSD) and dissociation. Eye movement desensitization and reprocessing (EMDR) has proved to be effective in the treatment of PTSD, anxiety states, dissociative symptoms and somatoform disorders. This study, which utilized a non-controlled qualitative multiple revelatory case design, integrates EMDR into the psychological treatment of PNES patients with confirmed trauma experiences. With EMDR targeting trauma and dissociative symptoms in three patients, PNES were extinguished in two. Those patients have remained seizure-free for 12-18 months.

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“…Physical examination should check for signs of medical and/or neurologic conditions including neoplasms, autoimmune diseases, demyelinating disorders, infections, vascular disease, and dementia. Pseudoseizures may be suggested by signs that are atypical of seizures, change with time, or persist in the interictal period; those with a history of conversion disorder may have numbness, weakness, unresponsiveness, limpness, and fainting [63,Class II]. An algorithm has been described for the use of diagnostic tests to evaluate potential seizures [64,Class III].…”

Section: Diagnosismentioning

confidence: 99%

An integrated neuropsychiatric approach to diagnosis and management of patients with epileptic seizures

Hilty

Bourgeois²,

Sugden³

et al. 2005

Curr Treat Options Neurol

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In patients who present to neurology settings with history of epileptic seizures, psychiatric disorders may be the sole manifestation of apparent neurologic symptoms, or they may coexist. Current challenges for clinicians include distinguishing between two disorders and making the correct diagnoses, interpreting test results, and (co-) managing the disorder(s). Our goal is to provide the clinician with an integrated neuropsychiatric approach for the triage, assessment (history, screening tools, examination, diagnostic tests), and treatment (neurologic and/or psychiatric) of these challenging patients. In particular, use of schemata, tables, and algorithms will offer step-by-step approaches and guidelines for the clinician. Recommendations are made for the indications for psychiatric consultation, and co-management is recommended for patients with emergencies, those who fail routine psychiatric treatments, and those with complex presentations or multiple comorbid conditions.

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Psychogenic seizures: clinical features and psychological analysis

Cited by 100 publications

References 24 publications

Psychogenic nonepileptic seizures and movement disorders

Psychogenic nonepileptic seizures and movement disorders

Eye movement desensitization and reprocessing in the psychological treatment of trauma‐based psychogenic non‐epileptic seizures

An integrated neuropsychiatric approach to diagnosis and management of patients with epileptic seizures

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