The Diagnostic Significance of Video‐EEG Monitoring Findings on Pseudoseizure Patients Differs Between Neurologists and Psychiatrists

Harden, Cynthia L.; Burgut, F. Tuna; Kanner, Andrés M.

doi:10.1046/j.1528-1157.2003.33002.x

Cited by 96 publications

(37 citation statements)

References 10 publications

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“…Previous research on psychogenic non-epileptic seizures (PNES) have shown that there is a significant difference in opinions regarding EEG results between psychiatrists and neurologists. In a study by Harden et al (2003) psychiatrists were found to have a lot less confidence in EEG results and accuracy in aiding the diagnosis of psychogenic symptoms than neurologists.…”

Section: Discussionmentioning

confidence: 99%

The role of the standard EEG in clinical psychiatry

O’Sullivan

Mullins

Cassidy

et al. 2006

Human Psychopharmacology

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Section: Discussionmentioning

confidence: 99%

The role of the standard EEG in clinical psychiatry

O’Sullivan

Mullins

Cassidy

et al. 2006

Human Psychopharmacology

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“…Among neurologists, the inter-rater reliability for video-EEG diagnosis of PNES is only moderate. 58 When the disciplines of Neurology and Psychiatry were surveyed with regard to how much they “believed” the v-EEG diagnosis of PNES, 70% of neurologists, but only 18% of psychiatrists, answered “most of the time.” 59 There is certainly a need to “build bridges” between these disciplines and, in particular, to educate mental health professionals in order to help patients be properly diagnosed and receive the timely treatment they need.…”

Section: Challenges In the Management Of Pnesmentioning

confidence: 99%

Treatment of Psychogenic Nonepileptic Seizures

et al. 2014

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Psychogenic non-epileptic seizures (PNES) were first described in the medical literature in the 19th century as seizure-like attacks not related to an identified central nervous system lesion and are currently classified as a conversion disorder, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). While a universally accepted and unifying etiological model does not yet exist, several risk factors have been identified. Management of PNES should be based on interdisciplinary collaboration, targeting modifiable risk factors. The first treatment phase in PNES is patient engagement, which is challenging given the demonstrated low rates of treatment retention. Acute interventions constitute the next phase in treatment and most research studies focus on short-term evidence-based interventions. Randomized controlled pilot trials support cognitive-behavioral therapy. Other psychotherapeutic and psychopharmacological interventions have been less well-studied using controlled and uncontrolled trials. Within the discussion of acute interventions, we present a preliminary evaluation for feasibility of a mindfulness-based psychotherapy protocol in a very small sample of PNES patients. We demonstrated in 6 subjects that this intervention is feasible in real-life clinical scenarios and warrants further investigation in larger scale studies. The final treatment phase is long-term follow-up. Long-term outcome studies in PNES show that a significant proportion of patients remain symptomatic and experience continued impairments in quality of life and functionality. We believe that PNES should be understood as a disease that requires different types of intervention during the various phases of treatment.

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“…It ensures an unambiguous, consistent, and databased message. It limits misunderstanding that can occur when dealing with somatoform illnesses and keeps patients, family, and providers all "on the same page" (Harden, Burgut, & Kanner, 2003 ). Questions requiring medical and psychological expertise can be answered together.…”

Section: Reporting the Findingsmentioning

confidence: 99%