Nonepileptic Psychogenic Seizures: Quagmires of Pathophysiology, Diagnosis, and Treatment

Devinsky, Orrin

doi:10.1111/j.1528-1157.1998.tb01405.x

Cited by 63 publications

(52 citation statements)

References 20 publications

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“…However, its value depends more heavily on constitutional factors than the values of the remaining indices that are more environmentally determined. This finding is consistent with earlier reports, which have drawn attention to the importance of family and environmental determinants of somatisation (Livingstone et al, 1995;Garralda, 1996;Devinsky, 1998;Owczarek, 2003b). …”

Section: Discussionsupporting

confidence: 83%

“…This factor adds to a conversion mechanism. Psychogenic nonepileptic seizures are a source of primary gain in the form of energetic discharges of internal conflicts and tensions and secondary gain in the form of other people's interest and care (Devinsky, 1998). Our study confirmed this hypothetical mechanism (high Hy2, Hy3 and Hy4 scores).…”

Section: Discussionsupporting

confidence: 78%

“…According to the literature, the factors frequently reported to lead directly or indirectly to psychogenic nonepileptic seizures include anxiety, difficulty controlling internal tensions and needs, and attention disorders (Devinsky, 1998;Donofrio et al, 2000;Swanson et al, 2000;Mökleby et al, 2002;Owczarek, 2002). Patients with PNES who have blatant anxiety symptoms can be classified as having one of the following four anxiety disorders: anxiety disorder without agoraphobia, anxiety disorder with agoraphobia, post-traumatic stress disorder (PTSD), or acute post-traumatic stress.…”

Section: Anxiety Dimensionsmentioning

confidence: 99%

See 2 more Smart Citations

Personality Profiles of Patients with Psychogenic Nonepileptic Seizures

Owczarek¹,

Jędrzejczak²

2012

Epilepsy - Histological, Electroencephalographic and Psychological Aspects

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 78%

Section: Anxiety Dimensionsmentioning

confidence: 99%

See 1 more Smart Citation

Personality Profiles of Patients with Psychogenic Nonepileptic Seizures

Owczarek¹,

Jędrzejczak²

2012

Epilepsy - Histological, Electroencephalographic and Psychological Aspects

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“…The percentage is greater, however, among individuals with a diagnosis of refractory epilepsy, ranging from 20 to 45%. [4][5][6][7] Among these patients, about 75% are females in the 20-30 years age bracket. [8][9][10][11] The main psychiatric co-morbidity in patients with epilepsy is depression.…”

mentioning

confidence: 99%

Neuropsychological aspects of psychogenic nonepileptic seizures

Portuguez

Costa

Marroni

et al. 2007

J. epilepsy clin. neurophysiol.

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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.Key words: psychogenic nonepileptic seizures, neuropsychological evaluation. RESUMO Aspectos neuropsicológicos de crises não-epilépticas psicogênicasCrises não-epilépticas psicogênicas podem ser definidas como episódios de alterações paroxísticas no comportamento, similares a crises epilépticas, porém não associadas a alterações quantificáveis da atividade elétrica cerebral. No Programa de Cirurgia de Epilepsia do Hospital São Lucas da PUCRS estudamos 52 indivíduos (37 mulheres e 15 homens) com o diagnóstico de CNEP, associadas (57%) ou não (23%) a epilepsia refratária. Aspectos psicológicos nesta população incluíram abuso emocional (100%), abuso físico (80%), negligência física (70%), abuso sexual (30%), desordens de humor (40%) e ansiedade (50%). O impacto médico e psicossocial deste diagnóstico é elevado, fazendo contraponto a carência de serviços especializados em seu tratamento. Múltiplos procedimentos diagnósticos e terapêuticos e a participação de um time multiprofissional -onde a neuropsicologia representa o elo natural entre a psicopatologia e o cérebro -são necessários para o melhor atendimento a estes pacientes.

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“…Furthermore, the social stigma attached to a diagnosis of epilepsy is considerable. Patients who have endured such stigma for any length of time may, understandably, become hostile when informed of a diagnostic change stating that their seizures are psychogenic rather than epileptic in nature [7]- [9].…”

Section: Introductionmentioning

confidence: 99%

Psychogenic Nonepileptic Seizures in Men: Comparison of Clinical and Psychosocial Features between Afro-American and Caucasian Patients

Abubakr¹,

Wambacq²

2014

JBBS

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PNES represents an alternative diagnosis for refractory epilepsy in the EMU, however it is less frequent in males. The impact of ethnicity on PNES was evaluated retrospectively in 54 males with confirmed diagnosis of PNES. We evaluated and compared the demographic, clinical and psychosocial characteristics of both AAMs and WMs. In both AAMs and CMS, over half of all patients were <50 years of age, had a shorter history of spells, and took between 1 to 3 AEDS. However, the spells were more frequent in AAM (2.25) compared to CM, but the CMs had more frequent limp/unresponsive events. Also there was higher incidence of head injury report, alcohol and substance abuse, unemployment and disability benefits in AAMs compared to CMs. These differences may provide insight into the causative factors in PNES.

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Nonepileptic Psychogenic Seizures: Quagmires of Pathophysiology, Diagnosis, and Treatment

Cited by 63 publications

References 20 publications

Personality Profiles of Patients with Psychogenic Nonepileptic Seizures

Personality Profiles of Patients with Psychogenic Nonepileptic Seizures

Neuropsychological aspects of psychogenic nonepileptic seizures

Psychogenic Nonepileptic Seizures in Men: Comparison of Clinical and Psychosocial Features between Afro-American and Caucasian Patients

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