Comparative Study of Trauma-Related Phenomena in Subjects With Pseudoseizures and Subjects With Epilepsy

Fleisher, William; Staley, Douglas; Krawetz, Patricia; Pillay, Neelon; Arnett, John L.; Maher, John

doi:10.1176/appi.ajp.159.4.660

Cited by 64 publications

(28 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…'I feel nothing', 'I do not know anything has happened') Oto & Reuber It is important to point out again that some of the features listed in Table 2 may also be noted in the background of patients with epilepsy; for example, a traumatic (as distinct from specifically sexually traumatic) past does not distinguish clearly between patients with or without epilepsy (Fleisher 2002).…”

Section: Box 1 Clinical Features Of Attacks Suggestive Of Psychogenicmentioning

confidence: 99%

Psychogenic non-epileptic seizures: aetiology, diagnosis and management

Oto¹,

Reuber²

2014

Adv. psychiatr. treat

View full text Add to dashboard Cite

SummaryPsychogenic non-epileptic seizures (PNES) have a significant impact on most patients in terms of distress, disability, loss of income and iatrogenic harm. Three-quarters of patients with PNES are initially misdiagnosed and treated for epilepsy. Misdiagnosis exposes patients to multiple iatrogenic harms and prevents them from accessing psychological treatment. In most cases, the patient's history (and witness accounts) should alert clinicians to the likely diagnosis of PNES. Since this diagnosis may be resisted by patients and may involve ‘un-diagnosing’ epilepsy, video-electroencephalogram recording of typical seizures is often helpful. The underlying causes of PNES are diverse: a model combining predisposing, precipitating and perpetuating factors is a useful way of conceptualising their aetiology. The initial step of treatment should be to limit iatrogenic harm. There is some evidence for the effectiveness of psychotherapy.

show abstract

Section: Box 1 Clinical Features Of Attacks Suggestive Of Psychogenicmentioning

confidence: 99%

Psychogenic non-epileptic seizures: aetiology, diagnosis and management

Oto¹,

Reuber²

2014

Adv. psychiatr. treat

View full text Add to dashboard Cite

show abstract

“…Among patients with PNES, 25%-42% concurrently experienced other somatoform symptoms and 84% had experienced other dissociative symptoms at some time in their life (Bowman & Markand, 1996). PNES patients have been found to have more dissociative symptoms than epilepsy patients (Fleisher et al, 2002), and nonclinical control groups (Goldstein, Drew, Meilers, Mitchell-O'Malley, & Oakley, 2000). A symptom profile of a series of 62 Australian patients who met the diagnostic criteria for Dissociative Identity Disorder (DID) indicated that 26% suffered seizures, a rate that is well in excess of usual prevalence rates of epilepsy (Middleton & Butler, 1998).…”

Section: Dissociationmentioning

confidence: 99%

Conceptualization and Treatment of Psychogenic Non-Epileptic Seizures

Quinn

Schofield

Middleton³

2008

Journal of Trauma & Dissociation

View full text Add to dashboard Cite

Psychogenic non-epileptic seizures (PNES) frequently present co-morbidly with a range of somatic and psychiatric conditions. This review discusses the relationship between PNES, a number of co-morbid psychiatric symptoms, early attachment trauma, and disruption of neurological development. We suggest that it may be clinically useful to understand PNES with reference to three patterns of co-morbidity and trauma history. In the first group, PNES are one symptom of a response to severe, chronic trauma and invalidation in attachment relationships, or a response to a recent event that overwhelms an emotion regulation system shaped by attachment trauma. For a second group, PNES occur in the context of ongoing interruptions to self and memory with or without a history of attachment trauma. For a third group, PNES occur in the absence of extensive co-morbidity and apparent trauma, primarily as a panic reaction, in a population with under-developed emotion regulation skills. Treatment approaches consistent with these conceptualizations are suggested.

show abstract

“…Indeed, Torem (1993) reported that PNES ceased permanently after trauma was addressed in alters of dissociative identity disorder patients. Fleisher et al (2002) compared patients with epilepsy with patients with PNES and found that the latter exhibited significantly different trauma profiles. These authors suggested that 'interventions aimed at trauma issues may be beneficial for patients with pseudoseizures [sic]' (p. 662).…”

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

View full text Add to dashboard Cite

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.

show abstract

Comparative Study of Trauma-Related Phenomena in Subjects With Pseudoseizures and Subjects With Epilepsy

Cited by 64 publications

References 16 publications

Psychogenic non-epileptic seizures: aetiology, diagnosis and management

Psychogenic non-epileptic seizures: aetiology, diagnosis and management

Conceptualization and Treatment of Psychogenic Non-Epileptic Seizures

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

Contact Info

Product

Resources

About