What is “treatment as usual” for nonepileptic seizures?

LaFrance, W. Curt; Rusch, Mark D.; Machan, Jason T.

doi:10.1016/j.yebeh.2007.12.017

Cited by 78 publications

(96 citation statements)

References 21 publications

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“…10,11 Variability of provision also appears marked in terms of access to treatment. A number of studies suggest that psychological treatment is beneficial for many patients, [12][13][14] and most neurologists consider psychological therapy the treatment of choice.…”

Section: Introductionmentioning

confidence: 99%

Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force

Hingray¹,

et al. 2017

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SummaryObjective: Studies from a small number of countries suggest that patients with psychogenic nonepileptic seizures (PNES) have limited access to diagnostic and treatment services. The PNES Task Force of the International League Against Epilepsy (ILAE) carried out 2 surveys to explore the diagnosis and treatment of PNES around the world. Methods: A short survey (8 questions) was sent to all 114 chapters of the ILAE.A longer survey (36 questions) was completed by healthcare professionals who see patients with seizures. Questions were separated into 5 sections: professional role, diagnostic methods, management, etiology, and access to health care. Results: Responses were received from 63 different countries. The short survey was completed by 48 ILAE chapters, and the long survey by 1098 health professionals from 28 countries. PNES were recognized as a diagnostic and therapeutic problem in all countries. Trauma and mental health issues were most commonly recognized as etiologic factors. There was a clear relationship between income and access to diagnostic tests and expertise. Psychological therapy was most commonly considered the treatment of choice. Although financial difficulties were the most commonly reported problem with service access in low-income countries, in

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Section: Introductionmentioning

confidence: 99%

Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force

Hingray¹,

et al. 2017

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“…In a survey by LaFrance et al in 2008, the most frequently used terms were "nonepileptic seizures" and "spells", with a minority of participants using "pseudoseizures" and "psychogenic seizures" (12). The sample surveyed was a specialist group, which would have more experience with this disorder than other clinicians, and with the survey title as "nonepileptic seizures", this may have biased respondents towards selecting this as their preferred term.…”

Section: Clinician Perspectivesmentioning

confidence: 99%

“…Morgan et al (2013) adapted the above approach to the paediatric setting, finding that parents preferred "non-epileptic events" above all (12), and, in contrast to the previous study, found "non epileptic attack disorder" to be less offensive than "functional". Like the preceding studies, it employed a hypothetical scenario without direct personal significance, but it had a broader study base than the previous two, recruiting from three sites, and handed out questionnaires rather than the researcher administering them, so should have less of any 'interviewer effect' than the above.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Conversion disorder: A systematic review of current terminology

Ding

Kanaan

2017

General Hospital Psychiatry

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Objective: It has been argued that the label given to unexplained neurological symptoms is an important contributor to their often poor acceptance, and there has been recent debate on proposals to change the name from Conversion Disorder. There have been multiple studies of layperson and clinician preference and this article aimed to review these.Design: Multiple databases were searched using terms including "conversion disorder" and "terminology", and relative preferences for the terms extracted.Results: Seven articles were found which looked at clinician or layperson preferences for terminology for unexplained neurological symptoms. Most neurologists favoured terms such as "functional" and "psychogenic", while laypeople were comfortable with "functional" but viewed "psychogenic" as more offensive; "Non-epileptic/organic" was relatively popular with both groups.Conclusions: "Functional" is a term that is relatively popular with both clinicians and the public. It also meets more of the other criteria proposed for an acceptable label than other popular terms -however the views of neither psychiatrists nor actual patients with the disorder were considered.

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“…If a diagnosis of PNES is established, most patients are referred on for further psycho logical treat ment (LaFrance 2008;Mayor 2011), although there is little evidence in favour of any particular psychotherapeutic management strategy.…”

Section: Non-pharmacological Treatmentmentioning

confidence: 99%

“…There is evidence that reduction or cessation of seizures, although useful as an objective clinical outcome measure, may not correlate with psychosocial recovery or quality of life, and the importance of including comprehensive and relevant psychosocial measures of outcome has been stressed by a number of authors (LaFrance 2008;Reuber 2008;Lawton 2010).…”

Section: Outcome Measuresmentioning

confidence: 99%

Psychogenic non-epileptic seizures: aetiology, diagnosis and management

Oto¹,

Reuber²

2014

Adv. psychiatr. treat

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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.

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What is “treatment as usual” for nonepileptic seizures?

Cited by 78 publications

References 21 publications

Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force

Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force

Conversion disorder: A systematic review of current terminology

Psychogenic non-epileptic seizures: aetiology, diagnosis and management

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