Sustained improvement with mindfulness-based therapy for psychogenic nonepileptic seizures

Baslet, Gaston; Ridlon, Robert; Raynor, Geoffrey; Gonsalvez, Irene; Dworetzky, Barbara A.

doi:10.1016/j.yebeh.2021.108478

Cited by 11 publications

(3 citation statements)

References 22 publications

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“…Baslet et al [44] observed a significant reduction in PNES frequency, intensity, and number of days per week with PNES at four months follow up after mindfulness-based therapy. Illness perception and feeling understood remained improved at this point.…”

Section: Management Of Psychogenic Nonepileptic Seizuresmentioning

confidence: 98%

An update on psychogenic nonepileptic seizures

Vijay,

Reuber

2024

Current Opinion in Neurology

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Purpose of review The understanding of psychogenic nonepileptic seizures (PNES) has advanced steadily over recent decades. This update summarizes new insights from the last three years. Recent findings The process of diagnosing PNES has shifted from the exclusion of epilepsy to one based on the recognition of typical clinical features. While the diagnosis cannot rely on any single feature in isolation, a range of semiological features characterising PNES are now recognised and a number of studies hint at the potential for machine learning and AI to improve the diagnostic process. Advances in data processing and analysis may also help to make sense of the heterogeneity of PNES populations demonstrated by recent studies focussing on aetiology and patient subgroups. It is now clear that PNES are associated with high rates of mental and physical comorbidities and premature death, highlighting that they are only one manifestation of a complex disorder extending beyond the nervous system and the seizures themselves. Summary PNES are now understood as a manifestation of dysfunction in interacting brain networks. This understanding provides an explanation for the psychopathological and semiological heterogeneity of PNES patient populations. New insights into medical comorbidities and increased rates of premature death call for more research into associated pathological processes outside the nervous system.

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Section: Management Of Psychogenic Nonepileptic Seizuresmentioning

confidence: 98%

An update on psychogenic nonepileptic seizures

Vijay,

Reuber

2024

Current Opinion in Neurology

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“…Two prospective uncontrolled studies of mindfulnessbased psychotherapeutic approaches conducted in FS patients to improve awareness and acceptance of internal states demonstrated improvement in FS intensity and worry [124,125]. In one of the studies, some outcomes were maintained 6 months post-treatment [124].…”

Section: Evidence For Other Therapeutic Approachesmentioning

confidence: 99%

Functional Neurological Disorder: Historical Trends and Urgent Directions

Velazquez-Rodriquez,

Fehily

2023

J Neurol Res

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The objective was to identify the gaps in understanding and management of functional neurological disorders (FNDs) that could be negatively impacting its incidence, prevalence, prognosis, and preventive tools. A narrative review was performed to synthetize evidence from multiple fields including genetic, epidemiological, functional neuroimaging and clinical studies, paying close attention to FND historical trends and recurring themes in nomenclature, classification, epidemiology, therapeutic tools, outcomes, prognosis, and pathophysiology. References included in this review were sourced from PubMed, covering January 1, 2000 to June 30, 2022, and from the references of relevant articles. Multiple problems associated with the current status of approach and management of FNDs were identified, including six major knowledge gaps. To overcome such shortfalls, we recommend the collaborative creation of a multi-network management algorithm that integrates all pathophysiological mechanisms involved in FND onset and perpetuation. It is hoped that an integrative model will facilitate the development of a biographically focused, biopsychosocial-spiritual management and preventive protocol, which incorporates key concepts and skills from the fields of neurology, psychiatry, psychology, and physiotherapy. Such comprehensive and concise protocol could be distributed through upskill programs across several medical specialties. Multidisciplinary collaboration is needed to fill current knowledge gaps, with multispecialty teams helping to overcome the deficits in outcomes and prognosis still affecting FND, one of the commonest and most expensive neurological disorders currently affecting humankind.

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“…In patients with episodic symptoms, specific CBT techniques are used to enable patients to recognize premonitory autonomic or somatic symptoms that may precede their episodes. Mindfulness-based psychotherapies may also help patients with FND gain awareness of their emotional and bodily responses to relevant stimuli [34]. Other forms of therapy, including psychodynamic psychotherapy and trauma therapies may also be of help [31] and it may be helpful to consult with a neuropsychiatrist or a psychologist to determine the most fitting mode of psychotherapy for a given patient.…”

Section: Management Of Fnd: the Multidisciplinary Approachmentioning

confidence: 99%

Functional Neurological Disorder in Saudi Arabia: An Update

Tayeb

2023

Cureus

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Functional neurological disorder (FND) is characterized by neurological symptoms that lack congruence with traditional neurological diagnoses. Historically viewed through a Freudian psychoanalytic lens, FND has been conceptualized as a purely psychogenic disorder. However, the contemporary biopsychosocial perspective on FND emphasizes contributions of cognitive and neural circuit dysfunction and the disabling and involuntary nature of the illness. In Saudi Arabia, evidence suggests the prevalence of FND is significant. However, clinical programs and research focused on FND have been lacking. Studies from the region indicate that practitioners may have outdated views of FND. To address this, this narrative review provides an updated perspective on FND that is relevant to Saudi Arabia and the region. It delves into the evolving perception of FND, its underlying pathophysiology, risk factors, clinical presentations, and recent diagnostic and management advances. Unique features of FND in Saudi Arabia may include a significant role for family disputes as a risk factor, prevalent supernatural perceptions of FND, high prevalence of somatization, and cognitive dysfunction, and a potential favorable prognosis. The article concludes by providing the following recommendations related to FND in Saudi Arabia and the region: i) building educational programs to update clinicians about contemporary biopsychosocial perspectives on FND; ii) emphasizing a positive diagnostic approach based on clinical findings in FND; iii) instituting multidisciplinary programs to care for FND patients; iv) supporting systematic research efforts to explore culture-specific FND risk factors, patient outcome measures, and attitudes toward the disorder; v) developing national FND clinical practice guidelines; and vi) launching awareness campaigns to reduce FND stigma.

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Sustained improvement with mindfulness-based therapy for psychogenic nonepileptic seizures

Cited by 11 publications

References 22 publications

An update on psychogenic nonepileptic seizures

An update on psychogenic nonepileptic seizures

Functional Neurological Disorder: Historical Trends and Urgent Directions

Functional Neurological Disorder in Saudi Arabia: An Update

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