Psychogenic non-epileptic seizures in children – psychophysiology &amp; dissociative characteristics

Sawchuk, Tyson; Buchhalter, Jeffrey; Senft, Birgit

doi:10.1016/j.psychres.2020.113544

Cited by 14 publications

(16 citation statements)

References 44 publications

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“…All these clinicians and their teams have contributed to recent advances in theory, best-practice guidelines, and evaluation of treatment outcomes, thereby providing direction for clinicians around the world (see Supplemental Text Box 2, http://links.lww.com/HRP/A210). 10,11,15,20,25,37,40,43,58,59,74,80,81,92,108–128 Through collaborative efforts, these teams have also worked hard to highlight that the pressing need to develop an FND-informed culture of care that takes into account recent advances in our understanding and clinical care of children and adolescents with FND 26 …”

Section: Discussionmentioning

confidence: 99%

“…In children with FND-and especially those with functional seizures-an increased respiratory rate alongside autonomic activation is a common finding. 11,72 Slow-paced breathing facilitates an increase of vagal tone because the nucleus ambiguous (vagal nucleus) sits next to, and is connected with, inspiratory and expiratory neurons of the central pattern generator for respiration. 93 The systems are coupled.…”

Section: Learning and Practicing Mind-body Regulation Strategiesmentioning

confidence: 99%

“…unctional neurological disorder (FND) in children (including adolescents) involves the biological embedding of lived experience in the body and brain,* culminating in stress-system activation or dysregulation and in aberrant changes in neural network function. [8][9][10][11][12] In pediatric neurology clinics, FND is common and represents up to 23% of new patients. 13,14 Current research shows good outcomes (see Supplemental Table 1, http://links.lww.com/HRP/A208).…”

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confidence: 99%

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Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder

Kozlowska

Chudleigh

Savage

et al. 2023

Harv Rev Psychiatry

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Learning objectives:• Develop and implement treatment plans for children and adolescents with functional neurological disorder (FND) • Outline a plan to increase awareness and standardize the care for patients with FND using evidence-based interventions Abstract: Functional neurological disorder (FND) in children and adolescents involves the biological embedding of lived experience in the body and brain. This embedding culminates in stress-system activation or dysregulation and in aberrant changes in neural network function. In pediatric neurology clinics, FND represents up to one-fifth of patients. Current research shows good outcomes with prompt diagnosis and treatment using a biopsychosocial, stepped-care approach. At present, however-and worldwide-FND services are scarce, the result of long-standing stigma and ingrained belief that patients with FND do not suffer from a real ("organic") disorder and that they therefore do not require, or even deserve, treatment. Since 1994, the Mind-Body Program for children and adolescents with FND at The Children's Hospital at Westmead in Sydney, Australia-run by a consultation-liaison team-has delivered inpatient care to hundreds of patients with FND and outpatient care to hundreds of others. For less-disabled patients, the program enables community-based clinicians to implement biopsychosocial interventions locally by providing a positive diagnosis (by a neurologist or pediatrician), a biopsychosocial assessment and formulation (by clinicians from the consultation-liaison team), a physical therapy assessment, and clinical support (from the consultation-liaison team and the physiotherapist). In this Perspective we describe the elements of a biopsychosocial mind-body program intervention capable of providing, as needed, effective treatment to children and adolescents with FND. Our aim is to communicate to clinicians and institutions around the world what is needed to establish effective community treatment programs, as well as hospital inpatient and outpatient interventions, in their own health care settings.

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Section: Discussionmentioning

confidence: 99%

Section: Learning and Practicing Mind-body Regulation Strategiesmentioning

confidence: 99%

mentioning

confidence: 99%

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Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder

Kozlowska

Chudleigh

Savage

et al. 2023

Harv Rev Psychiatry

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“… 22 Adults and children who experience psychogenic non-epileptic seizures (PNES) also have higher rates of dissociation. 23 Unaddressed trauma-related dissociation or DDs can also negatively impact treatment and medication adherence or pharmacological response. 18 , 24 …”

Section: Public Health Implications Of Untreated Ddsmentioning

confidence: 99%

Trauma-Related Dissociation and the Dissociative Disorders:

Boyer¹,

Caplan²,

Edwards³

2022

Delaware Journal of Public Health

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Trauma-related dissociation is a major public health risk warranting the attention of the healthcare professions. Severe dissociative pathology or dissociative disorders (DDs) are more prevalent than some commonly assessed psychiatric disorders (e.g., Bipolar Disorder, Obsessive Compulsive Disorder, Schizophrenia), yet are often under-recognized and undertreated, despite being associated with significant disability and chronic medical issues, among many other severe and costly public health consequences. In fact, people living with DDs spend an average of 5 to 12.4 years actively engaged in treatment before receiving an accurate diagnosis. Detection and treatment of trauma-related dissociation and DDs leads to a myriad of positive outcomes including improved quality of life, treatment outcomes, reduction in health and social risks, decreased healthcare utilization and costs (25-64% reduction), and significant economic advantages for society. It is imperative that healthcare professionals are trained in recognizing, assessing, and treating dissociation in service of preventing the discussed public health consequences. This article provides a comprehensive review of the important public health implications resulting from often neglected or untreated trauma-related dissociation and DDs while offering a summary of assessment methods, treatments, and resources to empower individuals and healthcare professionals to effect change.

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“…Paroxysmal events can be classified into 3 major categories; namely epileptic seizures, non-epileptic seizures (NES), and psychogenic non-epileptic seizures (PNES). Epileptic seizures are caused by excessive and hypersynchronous neuronal discharge (ictal epileptiform activity); however, NES and PNES are not caused by ictal epileptiform activity [2][3][4][5][6][7]. It is estimated that approximately 20 % of the patients presented to the emergency department for the evaluation of paroxysmal events were misdiagnosed as epilepsy.…”

Section: Introductionmentioning

confidence: 99%

Non-epileptic paroxysmal events in paediatric patients: A single tertiary centre study in Egypt

Thabit

Sadek

Motawe

et al. 2021

Seizure

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Psychogenic non-epileptic seizures in children – psychophysiology & dissociative characteristics

Cited by 14 publications

References 44 publications

Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder

Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder

Trauma-Related Dissociation and the Dissociative Disorders:

Non-epileptic paroxysmal events in paediatric patients: A single tertiary centre study in Egypt

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