Association between Epilepsy and Psychogenic Non-Epileptic Seizures: A Case Report

Abstract

Epilepsy is a very complex disorder of the central nervous system. It is characterized by a sudden, disordered and excessive neuronal shock that causes different clinical evidences with specific related electroencephalogram (EEG). Psychogenic Non-Epileptic Seizures (PNES) can seriously complicate the diagnosis of epilepsy. The separoxysmal events have the same clinical evidences of epilepsy, such as an impairment of the self-control and a range of sensory, motor and mental manifestations, without the typical related electroencephalogram (EEG) because of the absence of an organic cause. The overwhelming majority of Psychogenic Non-Epileptic Seizures are related to psychological factors like dissociation. This is a defense mechanism used to cope stressful events or emotional conflicts. Psychological or psychiatric disorders, like Post Traumatic Stress Disorder (PTSD), are frequently associated to Psychogenic Non-Epileptic Seizures. In this article, we present a case report of epilepsy combined with Psychogenic Non-Epileptic Seizures. A joint intervention is of great significance in this occurrence. The subject received a psychological assessment including psychometric and projective tools. He stood MMPI-2, Wais-R, SCL-90, Rorschach test and graphic tests. A psychological disorder related to defense mechanisms was identified. The subject presents a tendency to convert his fears and emotive pains in rational and more socially acceptable problems, using his body to express his discomfort. Patient with epileptic seizures should receive a psychological assessment to exclude Psychogenic Non-Epileptic Seizures. Further studies should propose guidelines to integrate neurological, psychiatric and psychological intervention.