Eye movement desensitization and reprocessing treatment in functional neurological symptom disorder with psychogenic nonepileptic seizures: A study of two cases

Abstract

Patients with functional neurological symptom disorder (FND) have many diverse symptoms including psychogenic nonepileptic seizures (PNES), positive movements such as tremor, dystonia, or gait abnormalities, loss of motor function such as leg or arm paresis, and loss of sensory functions, such as blindness, deafness, or loss of feeling in the limbs. Eye movement desensitization and reprocessing (EMDR) is a therapy method that includes some techniques arising from psychodynamic, cognitive, and behavioral approaches. EMDR is known as a proven psychotherapeutic approach in post-traumatic stress disorder, but there are also numerous studies reporting its efficacy in other psychiatric disorders and trauma-associated symptoms, in patients with comorbid psychiatric disorders. This article presents the outcome of EMDR treatment of two patients’ cases, a 13-year-old female and a 16-year-old male, who were diagnosed as FND with PNES, according to the DSM-5 diagnostic criteria. In both cases, there was a significant decrease in Adolescent Dissociative Experiences Scale scores and no pseudo seizures were found, even at the sixth-month follow-up visits. These case studies suggest that EMDR can be an effective method in the long-term treatment of FND with PNES and a useful alternative to other treatment methods.

Toward a possible trauma subtype of functional neurological disorder: impact on symptom severity and physical health

“…Since the publication of this landmark study, several research groups have advocated for the need to refine the pairing of specific psychotherapy modalities to a given patient with FND based on clinical formulation (e.g., what else is present alongside this patient’s functional neurological symptoms) ( 51 – 53 ). For example, there is evidence to suggest that patients with FND-seiz and PTSD may benefit from prolonged exposure (PE) therapy ( 54 ); other psychotherapy treatment modalities such as dialectical behavioral therapy (DBT), eye movement desensitization and reprocessing (EMDR), mindfulness-based psychotherapy (MBT), and acceptance and commitment therapy (ACT) have all been piloted in FND populations ( 55 – 58 ). Operationalizing a trauma-subtype of FND would facilitate increased recognition and research efforts to study how to best pair a given patient with FND to the psychotherapy modality they are most likely to benefit from.…”

Psychogenic Non-epileptic Seizures: An Update on Diagnosis and Management

“…In recent years, eye movement desensitization and reprocessing (EMDR) has also been proposed in the treatment pf patients diagnosed with PNES and post-traumatic stress disorders [119]. However, it has not shown effective results when used as first line of treatment and it is more useful if associated with a battery of treatments [106].…”