scholarly journals Pszichogén nem epilepsziás rosszullétek a klinikai gyakorlatban

2016 ◽  
Vol 157 (20) ◽  
pp. 767-775 ◽  
Author(s):  
Bernadett Szita ◽  
Zoltán Hidasi
Keyword(s):  
Behavioral Therapy ◽  
Early Adulthood ◽  
Epileptic Seizures ◽  
Pharmacological Interventions ◽  
Psychogenic Nonepileptic Seizures ◽  
Traumatic Life Events ◽  
High Prevalence ◽  
Nonepileptic Seizures ◽  
The Brain ◽  
Video Eeg

Psychogenic nonepileptic seizures are enigmatic disorders at the interface of neurology and psychiatry. Seizures resemble epileptic seizures but are not associated with electrical discharges in the brain. Symptoms typically start in early adulthood and women are far more affected than men. Video-EEG is widely considered to be the gold standard for diagnosis. Still psychogenic nonepileptic seizures are often misdiagnosed and treated as epilepsy for years that is burdensome to patients and costly to the healthcare system. Patients having psychogenic nonepileptic seizures show a high prevalence of traumatic life events, therefore, psychosocial factors are thought to play an important role in the etiology. Neurobiological factors may also contribute to the development of seizures as a subgroup of patients are characterized by cognitive impairment and subtle structural and functional brain abnormalities. Treatment includes psychotherapeutic procedures, particularly cognitive behavioral therapy and additional pharmacological interventions. This article presents an overview of the clinical context, diagnosis, etiology and treatment of psychogenic nonepileptic seizures. Orv. Hetil., 2016, 157(20), 767–775.

scholarly journals Neuropsychological aspects of psychogenic nonepileptic seizures

2007 ◽  
Vol 13 (4 suppl 1) ◽  
pp. 24-27
Author(s):  
Mirna Wetters Portuguez ◽  
Danielle Irigoyen da Costa ◽  
Sabine Possa Marroni ◽  
Vanessa Pagliarini ◽  
Karin Vieira
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Multidisciplinary Team ◽  
Emotional Abuse ◽  
Epileptic Seizures ◽  
Mental Processes ◽  
Psychogenic Nonepileptic Seizures ◽  
Therapeutic Procedures ◽  
Nonepileptic Seizures ◽  
The Brain

Psychogenic nonepileptic seizures (PNES) may be defined as paroxysmal changes in behavior that are similar to epileptic seizures but are not associated with quantifiable alterations in the electrical activity of the brain. At the Epilepsy Surgery Program (ESP) of the São Lucas Hospital at PUCRS (HSL-PUCRS), we studied 52 individuals (37 females and 15 males) with a diagnosis of PNES, associated (57%) or not (23%) with refractory epileptic seizures. We found emotional abuse (100%), physical abuse (80%), emotional neglect (80%), physical negligence (70%) and sexual abuse (30%), mood (40%) and anxiety disorders (50%), as the main psychological components in such population. Although the medical and psychosocial impact of PNES can be estimated as significant, the absence of specialized services for its treatment is striking. Multiple diagnostic and therapeutic procedures and the participation of a specialized multidisciplinary team – where neuropsychology functions as a link between the mental processes/psychopathologies and the brain – are required to ensure proper management of such cases.

scholarly journals Psychogenic Nonepileptic Seizures after Head Injury: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Laura Scévola ◽  
Luciana D'Alessio ◽  
Dario Saferstein ◽  
Estela Centurión ◽  
Damián Consalvo ◽  
...  
Keyword(s):  
Head Injury ◽  
Epileptic Seizures ◽  
Medical Illness ◽  
Traumatic Head Injury ◽  
Psychogenic Nonepileptic Seizures ◽  
Traumatic Head ◽  
Nonepileptic Seizures ◽  
Electroencephalogram Eeg ◽  
Bus Accident ◽  
Video Eeg

Psychogenic nonepileptic seizures (PNESs) are diagnosed when disruptive changes in behaviour, thinking, or emotion resemble epileptic seizures (ESs), but no paroxysmal discharges are seen on electroencephalogram (EEG) and do not originate from another medical illness. The gold standard for PNES diagnosis is video electroencephalogram (Video-EEG). PNESs are defined by modern psychiatry as conversion and dissociative disorders but these disorders may coexist with many others psychiatric disorders, including depression, posttraumatic stress disorder, and personality disorders. It is well known that epileptic seizures are a frequent and well-studied complication of traumatic head injury (THI). However, THI may also generate psychic symptoms including PNES. In this paper we describe a patient who developed PNES after THI in a bus accident and received a diagnosis of refractory epilepsy for 24 years until she underwent Video-EEG.

scholarly journals Pseudoseizure with Pseudo-ventricular Tachycardia

2018 ◽  
Vol 04 (01) ◽  
pp. 28
Author(s):  
Ozlem Karabulut ◽  
Ozcan Ozeke ◽  
Ilke Erbay ◽  
Ertan Ekici ◽  
Serkan Cay ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Body Movement ◽  
Epileptic Seizures ◽  
Clinical History ◽  
Careful Analysis ◽  
Interesting Case ◽  
Psychological Disturbance ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures ◽  
The Brain

Psychogenic nonepileptic seizures (PNES), or pseudoseizures, are paroxysmal episodes that resemble, and are often misdiagnosed as, epileptic seizures; however, they are psychological (i.e., emotional, stress-related) in origin. Unlike epileptic seizures, PNES do not result from an abnormal electrical discharge from the brain; they are a physical manifestation of a psychological disturbance. We present an interesting case of PNES with pseudo-ventricular tachycardia due to body movement related artefacts. A careful analysis of the whole 12-lead electrocardiogram is required to rule out an artefact-related appearance of ventricular tachycardia. Correct interpretation of electrocardiograms and their co-relation to clinical history and presentation is key.

scholarly journals Epilepsy surgery in patients with coexisting psychogenic nonepileptic seizures: diagnosis and treatment

2007 ◽  
Vol 13 (4 suppl 1) ◽  
pp. 36-38 ◽  
Author(s):  
Luiz Henrique Martins Castro
Keyword(s):  
Psychiatric Treatment ◽  
Clinical Skills ◽  
Diagnostic Testing ◽  
Epileptic Seizures ◽  
Family Counseling ◽  
Relative Role ◽  
Eeg Monitoring ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures ◽  
Video Eeg

The prevalence of epileptic seizures among patients with psychogenic nonepileptic seizures may range from five to fifty percent. Diagnosis of both conditions occurring in association may be difficult and requires both clinical skills and prolonged video-EEG monitoring. Occurrence of seemingly psychogenic events during video-EEG monitoring should be interpreted with caution, and the relative role of both psychogenic and epileptic seizures in day-to-day living should be carefully evaluated for each individual patient. Surgery is not contraindicated in this setting, however patients and family members should be educated about both conditions before surgical decision. Psychogenic seizures and other psychiatric co-morbidities should be properly assessed and treated before surgery. Diagnosis and management of postoperative events (epileptic or psychogenic) is challenging. This difficulty can be minimized by appropriate presurgical management, that includes diagnostic testing, neurologic and psychiatric treatment and patient and family counseling.

Comparison of outcomes of video/EEG monitoring between patients with epileptic seizures and those with psychogenic nonepileptic seizures

2009 ◽  
Vol 15 (3) ◽  
pp. 303-307 ◽  
Author(s):  
Yi-Chen Zhang ◽  
Edward B. Bromfield ◽  
Shelley Hurwitz ◽  
Aaron Nelson ◽  
Kristen Sylvia ◽  
...  
Keyword(s):  
Epileptic Seizures ◽  
Eeg Monitoring ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures ◽  
Video Eeg

Epilepsy and Related Disorders

2018 ◽  
Author(s):  
Barbara Dworetzky ◽  
Jong Woo Lee
Keyword(s):  
Differential Diagnosis ◽  
Generic Drugs ◽  
Sudden Change ◽  
Epileptic Seizures ◽  
Quality Measures ◽  
The Elderly ◽  
Childhood And Adolescence ◽  
Nonepileptic Seizures ◽  
Infancy And Early Childhood ◽  
The Brain

Epilepsy is a chronic disorder of the brain characterized by recurrent unprovoked seizures. A seizure is a sudden change in behavior that is accompanied by electrical discharges in the brain. Many patients presenting with a first-ever seizure are surprised to find that it is a very common event. A reversible or avoidable seizure precipitant, such as alcohol, argues against underlying epilepsy and therefore against treatment with medication. This chapter discusses the epidemiology, etiology, and classification of epilepsy and provides detailed descriptions of neonatal syndromes, syndromes of infancy and early childhood, and syndromes of late childhood and adolescence. The pathophysiology, diagnosis, and differential diagnosis are described, as are syncope, migraine, and psychogenic nonepileptic seizures. Two case histories are provided, as are sections on treatment (polytherapy, brand-name versus generic drugs, surgery, stimulation therapy, dietary treatments), complications of epilepsy and related disorders, prognosis, and quality measures. Special topics discussed are women?s issues and the elderly. Figures illustrate a left midtemporal epileptic discharge, wave activity during drowsiness, cortical dysplasias, convulsive syncope, rhythmic theta activity, right hippocamal sclerosis, and right temporal hypometabolism. Tables describe international classifications of epileptic seizures and of epilepsies, epilepsy syndromes and related seizure disorders, differential diagnosis of seizure, differentiating epileptic versus nonepileptic seizures, antiepileptic drugs, status epilepticus protocol for treatment, when to consider referral to a specialist, and quality measures in epilepsy.  This review contains 7 figures, 10 tables, and 33 references. Key Words: Seizures, focal (partial)seizure, generalized seizures, Myoclonic seizures, Atonic seizures, Concurrent electromyographyTonic-clonic (grand mal) seizures

scholarly journals Nonepileptic seizures: an updated review

CNS Spectrums ◽  
2016 ◽  
Vol 21 (3) ◽  
pp. 239-246 ◽  
Author(s):  
David L. Perez ◽  
W. Curt LaFrance
Keyword(s):  
Behavioral Therapy ◽  
Epileptiform Activity ◽  
Epileptic Seizures ◽  
Clinical History ◽  
Conversion Disorder ◽  
Future Research ◽  
Treatment Interventions ◽  
Diagnostic Certainty ◽  
Typical Event ◽  
Nonepileptic Seizures

Psychogenic nonepileptic seizures (PNES) are a functional neurological disorder/conversion disorder subtype, which are neurobehavioral conditions at the interface of neurology and psychiatry. Significant advancements over the past decade have been made in the diagnosis, management, and neurobiological understanding of PNES. This article reviews published PNES research focusing on semiologic features that distinguish PNES from epileptic seizures, consensus diagnostic criteria, the intersection of PNES and other comorbidities, neurobiological studies, evidence-based treatment interventions, and outcome studies. Epidemiology and healthcare utilization studies highlight a continued unmet medical need in the comprehensive care of PNES. Consensus guidelines for diagnostic certainty are based on clinical history, semiology of witnessed typical event(s), and EEG findings. While certain semiologic features may aid in the diagnosis of PNES, the gold standard remains capturing a typical event on video electroencephalography (EEG) showing the absence of epileptiform activity with history and semiology consistent with PNES. Medical-neurologic and psychiatric comorbidities are prevalent in PNES; these should be assessed in diagnostic evaluations and integrated into treatment interventions and prognostic considerations. Several studies, including a pilot, multicenter, randomized clinical trial, have now demonstrated that a cognitive behavioral therapy–informed psychotherapy is an efficacious treatment for PNES, and additional efforts are necessary to evaluate the utility of pharmacologic and other psychotherapy treatments. Neuroimaging studies, while requiring replication, suggest that PNES may occur in the context of alterations within and across sensorimotor, emotion regulation/processing, cognitive control, and multimodal integration brain systems. Future research could investigate similarities and differences between PNES and other somatic symptom disorders.

Neurologist, 13 years’ experience, Australia

2020 ◽  
pp. 204-206
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Emergency Department ◽  
Behavioral Therapy ◽  
Epileptic Seizures ◽  
Clinical Psychologist ◽  
Eeg Monitoring ◽  
Patient Reported ◽  
History Of ◽  
Convulsive Seizures ◽  
One Year ◽  
Video Eeg

This chapter discusses the experience of a Neurologist with a patient who presented with a history of three bilateral convulsive seizures over a period of several months. The Neurologist started him on an adjunct antiepileptic therapy and he became seizure free. However, the situation changed dramatically after a stable period of twelve months. He started having seizures again and his mother was able to recognize that these seizures were different from those he had had one year earlier. Prolonged video-EEG monitoring confirmed the diagnosis of Non-Epileptic Seizures (NES). The Neurologist then referred the patient to a Clinical Psychologist, who used Cognitive Behavioral Therapy and taught him some techniques to cope with the condition. Eventually, the patient and his family were able to manage the NES better with the help of the psychologist. The patient reported a significant improvement clinically with less frequent NES and they learned how to manage the situation without visiting the Emergency Department.

scholarly journals Spectrum of Nonepileptic Paroxysmal Events in Children from Southern India

2019 ◽  
Vol 10 (04) ◽  
pp. 608-612
Author(s):  
Vykuntaraju K Gowda ◽  
Raghavendraswami Amoghimath ◽  
Naveen Benakappa ◽  
Sanjay K Shivappa
Keyword(s):  
Children And Adolescents ◽  
Age Of Onset ◽  
Age Groups ◽  
Epileptic Seizures ◽  
Breath Holding ◽  
Home Video ◽  
Psychogenic Nonepileptic Seizures ◽  
Wrong Diagnosis ◽  
Nonepileptic Seizures ◽  
Eeg Recordings

Abstract Background Nonepileptic paroxysmal events (NEPEs) present with episodes similar to epileptic seizures but without abnormal electrical discharge on electroencephalogram (EEG). NEPEs are commonly misdiagnosed as epilepsy. Epilepsy is diagnosed on the basis of a detailed history and examination. Emphasis during history to rule out the possibility of NEPE is important. The wrong diagnosis of epilepsy can lead to physical, psychological, and financial harm to the child and the family. Hence, this study was planned. Objective The objective of the study is to evaluate clinical profile, frequency, and spectrum of NEPE in children. Materials and Methods This is a prospective observational study. Patients with NEPE between January 2014 and August 2016 aged < 18 years were enrolled. NEPEs were diagnosed on the basis of history, home video, and EEG recordings. Patients were divided into different categories according to age, specific type of disorder, and system responsible. Patients were followed for their NEPE frequency and outcome. Results A total of 3,660 children presented with paroxysmal events; of them 8% were diagnosed with NEPE. Patients diagnosed with NEPE were classified into three age groups on the basis of their age of onset of symptom; of the total 285 patients, there were 2 neonates (0.7%), 160 infants (56%), and 123 children and adolescents (43.1%). Fifty-eight percent patients were boys. The most common diagnoses were breath-holding spells 113 (39%), followed by syncope 38 (13.3%) and psychogenic nonepileptic seizures 37 (12.9%). About 9 and 5% of patients had concomitant epilepsy and developmental delay, respectively. Conclusions NEPEs account for 8% of paroxysmal events. Most common NEPEs were breath-holding spells among infants and syncope and “psychogenic nonepileptic seizures” in children and adolescents.

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