Epilepsy in patients with psychogenic non-epileptic seizures

Marchetti, R.; Kurcgant, Daniela; Neto, José Gallucci; Bismark, Mary Ann Von; Fiore, Lia Arno

doi:10.1590/s0004-282x2010000200003

Cited by 18 publications

(12 citation statements)

References 25 publications

(32 reference statements)

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“…This variability in different studies may reflect several methodological aspects. A study carried in a Brazilian tertiary center found this association occurring in 50% of PNES patients 26 , a higher association 28 . In contrast, a correct diagnosis or a therapeutic communication can reduce or even abolish PNES in a significant amount of patients, at least temporally 28 , although if no treatment is proposed after communication, seizures may return, or even the appearance of new medically unexplained symptoms 20,28 .…”

Section: Diagnosis During Video Eegmentioning

confidence: 92%

“…Routine activation procedures (hyperventilation and photic stimulation) can be used during EEG for seizure induction and do not pose the risk of compromising the physician-patient alliance. Approximately 10% of patients with PNES have epilepsy, when studied using the most stringent criteria 26 . Other reports show a range from 5.3 to 73% of patients with PNES with mixed epilepsy 5,16,17,18,19,25,26 .…”

Section: Diagnosis During Video Eegmentioning

confidence: 99%

“…Approximately 10% of patients with PNES have epilepsy, when studied using the most stringent criteria 26 . Other reports show a range from 5.3 to 73% of patients with PNES with mixed epilepsy 5,16,17,18,19,25,26 . This variability in different studies may reflect several methodological aspects.…”

Section: Diagnosis During Video Eegmentioning

confidence: 99%

See 2 more Smart Citations

Psychogenic nonepileptic seizures and psychogenic movement disorders: two sides of the same coin?

Paola

Marchetti

Teive

et al. 2014

Arq. Neuro-Psiquiatr.

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Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are commonly seen in Neurology practice and are categorized in the DSM-5 as functional neurological disorders/conversion disorders. This review encompasses historical and epidemiological data, clinical aspects, diagnostic criteria, treatment and prognosis of these rather challenging and often neglected patients. As a group they have puzzled generations of neurologists and psychiatrists and in some ways continue to do so, perhaps embodying and justifying the ultimate and necessary link between these specialties.Keywords: psychogenic nonepileptic seizures, psychogenic movement disorders, conversion disorder, hysteria. RESUMOCrises não-epilépticas psicogênicas (CNEP) e distúrbios do movimento psicogênicos (DMP) são comuns na prática e na atualidade são melhor categorizados no DSM-V como distúrbios neurológicos funcionais/desordens de conversão. Esta revisão enfatiza os principais dados históricos, epidemiológicos, clínicos, critérios diagnósticos, tratamento e o prognóstico destes pacientes, frequentemente negligenciados e desafiadores, os quais, como um grupo, tem intrigado gerações de neurologistas e psiquiatras, caracterizando, de forma justificada o elo definitivo entre estas especialidades.Palavras-chave: crises não-epilépticas psicogênicas, distúrbios do movimento psicogênicos, distúrbio conversivo, histeria.In the medical sciences, a diagnosis is established when a level of certainty regarding the nature of a condition is achieved. Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) share a slightly less linear diagnostic route. Historically, making a conversion diagnosis required ruling out the originally considered medical diagnosis, i.e., it is neither epilepsy, nor a neurogenic movement disorder. Only then a non-neurologic (in the sense of not resulting from epileptogenic or known motor circuitry imbalance) condition is suspected and raised to the level of diagnosis 1 . This kind of diagnosis has intrigued generations of physicians and spared no culture, gender or age. A diversity of symptoms, including motor, sensory, cognitive, and/or behavior symptoms are present in these presentations. Patients with PNES or PMD frequently are misdiagnosed as having their initial suspected neurological diseases, and ultimately pose a diagnostic and treatment challenge to many clinicians. Interestingly, it was perhaps this varied presentation that has captured the attention of many professionals through the centuries and lead to the construction and recognition of a very particular diagnosis. Two rather advanced historic civilizations, Egyptians first, and then the Greeks, posited that a displaced hystera (womb), and the consequent suffocation that it produced, was the source of choking, mutism, paralysis and fainting 1 . Hysteria, a natural development on this concept, was claimed as an explanation for similar phenomena in women and reached almost epidemic proportions in the late 19 th century. By th...

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Section: Diagnosis During Video Eegmentioning

confidence: 92%

Section: Diagnosis During Video Eegmentioning

confidence: 99%

See 1 more Smart Citation

Psychogenic nonepileptic seizures and psychogenic movement disorders: two sides of the same coin?

Paola

Marchetti

Teive

et al. 2014

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…Such studies have addressed specific issues, such as comorbidity with epilepsy and with the most common psychiatric disorders [9,[21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Psychogenic non-epileptic seizures at a tertiary care center in Brazil

Alessi

Valente

2013

Epilepsy & Behavior

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Although psychogenic non-epileptic seizures (PNES) are a worldwide phenomenon, most of our knowledge addressing clinical characteristics is based on studies conducted in the USA, Europe, and Australia. There are scarce data about PNES in South American countries. This study provided a detailed analysis of the demographic, clinical, and psychosocial characteristics of 102 Brazilian patients with PNES. Seventy-eight patients (76.4%) were female with mean age of 35.27 years. Mean age at onset was 27.85 years; mean time to diagnosis was 7.89 years; 87.25% lived with their families; 56.89% were single; and only 33 (39.75%) worked on a regular basis. Depression was diagnosed in 48.03%. Thirty-three patients misdiagnosed as having epilepsy were using antiepileptic drugs. Stress factors were identified in 57.84%. This is the first Brazilian study that involves a large sample of patients with video-EEG-documented PNES and corroborates the idea that PNES are a worldwide phenomenon sharing several similarities, despite cultural and socioeconomic differences.

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“…Reviewing existing literature in LA reveals that a few studies focused on the prevalence of ES in patients diagnosed with PNES [10,11,26], and some have reviewed retrospective data for PNES identification purposes [13,27]. Stressing the treatment gap for PNES, literature in LA, largely from Argentina and Brazil, reveals that vEEG usage is highly suggested as a diagnostic tool (where available) to correctly diagnose the patients [10,[13][14][15]25,26,[28][29][30][31][32][33][34]. Studies in LA have identified higher frequencies of psychiatric comorbid diagnoses, such as anxiety and dissociation, than studies in the US [11,15,25,27,35,36].…”

Section: Introductionmentioning

confidence: 99%