Psychogenic Nonepileptic Seizures in Children with Epilepsy

2018 ◽  
Vol 07 (03) ◽  
pp. 106-110
Author(s):  
Asim Shahid ◽  
Rajkumar Agarwal
Keyword(s):  
Patient Outcome ◽  
Clinical Features ◽  
Management Strategies ◽  
Epileptic Seizures ◽  
Psychogenic Nonepileptic Seizures ◽  
Psychogenic Seizures ◽  
Nonepileptic Seizures ◽  
Simultaneous Existence ◽  
Underlying Pathophysiology ◽  
Improve Patient

AbstractThe occurrence of psychogenic seizures in a proportion of children with epilepsy has been well described. The diagnosis of simultaneous existence of nonepileptic and epileptic seizures is often challenging as the clinical features of these conditions may overlap. However, they differ significantly in terms of the underlying pathophysiology as well as management strategies. Timely recognition can prevent harmful treatments and potentially improve patient outcome. In this article, we focus on the epidemiology, clinical features as well as management of psychogenic seizures in children with epilepsy.

scholarly journals The relation of fibromyalgia and fibromyalgia symptoms to self-reported seizures

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246051
Author(s):  
Johannes J. Rasker ◽  
Frederick Wolfe ◽  
Ewa G. Klaver-Krol ◽  
Machiel J. Zwarts ◽  
Peter M. ten Klooster
Keyword(s):  
Epileptic Seizures ◽  
Small Samples ◽  
Similar Degree ◽  
Psychogenic Nonepileptic Seizures ◽  
Seizure Disorders ◽  
Psychogenic Seizures ◽  
Related Symptom ◽  
Patient Reported ◽  
Nonepileptic Seizures ◽  
Comorbidity Index

Objective Several epidemiological and clinical reports associate fibromyalgia (FM) with seizure disorders, and clinical studies associate FM diagnosis with psychogenic non-epileptic seizures. However, these associations rely on self-reports of being diagnosed with FM or unstandardized clinical diagnosis in combination with small samples. We investigated the association of FM and self-reported seizures using a large rheumatic disease databank and the current established self-reported, symptom-based FM diagnostic criteria. Methods We selected a random observation from 11,378 subjects with rheumatoid arthritis (RA), 2,390 (21.0%) of whom satisfied 2016 revised criteria for FM. Patients were inquired about the presence of any kind of seizures in the previous 6 months, anti-epileptic medications, and patient-reported symptoms and outcomes. Results Seizures were reported by 89 RA patients who met FM criteria (FM+) and by 97 patients who did not (FM-), resulting in an age- and sex-adjusted seizure prevalence of 3.74 (95% CI 2.95 to 4.53) per 100 FM+ subjects and 1.08 (95% CI 0.87 to 1.30) in FM- subjects. The seizure odds ratio of FM+ to FM- cases was 3.54 (95% CI 2.65 to 4.74). Seizures were associated to a very similar degree with symptom reporting (somatic symptom count and comorbidity index) as to FM diagnosis variables. RA patients reporting seizures also reported worse pain, quality of life, and functional status. Seizure patients treated with anti-seizure medication had worse outcomes and more comorbidities than seizure patients with no seizure drugs. Conclusions We found a significant and similar association of both FM diagnostic variables and FM-related symptom variables, including the number of symptoms and comorbidities, with self-reported seizures in people with RA. The observed association was similar to those found in previous studies of symptoms variables and seizures and does not suggest a unique role for fibromyalgia diagnosis. Rather, it suggests that multi-symptom comorbidity is linked to seizures in a complex and not yet clearly understood way. As the current study relied on self-reported seizures and was not able to distinguish between epileptic and psychogenic nonepileptic seizures, future studies are needed to replicate the findings using both validated FM criteria assessments and clinically verified diagnoses of epileptic and psychogenic seizures.

scholarly journals Neuropsychological aspects of psychogenic nonepileptic seizures

2007 ◽  
Vol 13 (4 suppl 1) ◽  
pp. 24-27
Author(s):  
Mirna Wetters Portuguez ◽  
Danielle Irigoyen da Costa ◽  
Sabine Possa Marroni ◽  
Vanessa Pagliarini ◽  
Karin Vieira
Keyword(s):  
Sexual Abuse ◽  
Physical Abuse ◽  
Multidisciplinary Team ◽  
Emotional Abuse ◽  
Epileptic Seizures ◽  
Mental Processes ◽  
Psychogenic Nonepileptic Seizures ◽  
Therapeutic Procedures ◽  
Nonepileptic Seizures ◽  
The Brain

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.

scholarly journals Spectrum of Nonepileptic Paroxysmal Events in Children from Southern India

2019 ◽  
Vol 10 (04) ◽  
pp. 608-612
Author(s):  
Vykuntaraju K Gowda ◽  
Raghavendraswami Amoghimath ◽  
Naveen Benakappa ◽  
Sanjay K Shivappa
Keyword(s):  
Children And Adolescents ◽  
Age Of Onset ◽  
Age Groups ◽  
Epileptic Seizures ◽  
Breath Holding ◽  
Home Video ◽  
Psychogenic Nonepileptic Seizures ◽  
Wrong Diagnosis ◽  
Nonepileptic Seizures ◽  
Eeg Recordings

Abstract Background Nonepileptic paroxysmal events (NEPEs) present with episodes similar to epileptic seizures but without abnormal electrical discharge on electroencephalogram (EEG). NEPEs are commonly misdiagnosed as epilepsy. Epilepsy is diagnosed on the basis of a detailed history and examination. Emphasis during history to rule out the possibility of NEPE is important. The wrong diagnosis of epilepsy can lead to physical, psychological, and financial harm to the child and the family. Hence, this study was planned. Objective The objective of the study is to evaluate clinical profile, frequency, and spectrum of NEPE in children. Materials and Methods This is a prospective observational study. Patients with NEPE between January 2014 and August 2016 aged < 18 years were enrolled. NEPEs were diagnosed on the basis of history, home video, and EEG recordings. Patients were divided into different categories according to age, specific type of disorder, and system responsible. Patients were followed for their NEPE frequency and outcome. Results A total of 3,660 children presented with paroxysmal events; of them 8% were diagnosed with NEPE. Patients diagnosed with NEPE were classified into three age groups on the basis of their age of onset of symptom; of the total 285 patients, there were 2 neonates (0.7%), 160 infants (56%), and 123 children and adolescents (43.1%). Fifty-eight percent patients were boys. The most common diagnoses were breath-holding spells 113 (39%), followed by syncope 38 (13.3%) and psychogenic nonepileptic seizures 37 (12.9%). About 9 and 5% of patients had concomitant epilepsy and developmental delay, respectively. Conclusions NEPEs account for 8% of paroxysmal events. Most common NEPEs were breath-holding spells among infants and syncope and “psychogenic nonepileptic seizures” in children and adolescents.

Validity testing in veterans with epileptic seizures and psychogenic nonepileptic seizures

2020 ◽  
Vol 111 ◽  
pp. 107246 ◽  
Author(s):  
Martin Salinsky ◽  
Laurence Binder ◽  
Daniel Storzbach ◽  
Karen Parko ◽  
Paul Rutecki ◽  
...  
Keyword(s):  
Epileptic Seizures ◽  
Validity Testing ◽  
Psychogenic Nonepileptic Seizures ◽  
Nonepileptic Seizures

Prolonged Exposure Therapy for Comorbid Psychogenic Nonepileptic Seizures and Posttraumatic Stress Disorder

2017 ◽  
Vol 17 (1) ◽  
pp. 3-20 ◽  
Author(s):  
Lorna Myers ◽  
Laurie Zandberg
Keyword(s):  
Posttraumatic Stress ◽  
Prolonged Exposure ◽  
Epileptic Seizures ◽  
Psychological Trauma ◽  
Psychogenic Nonepileptic Seizures ◽  
Full Remission ◽  
Stress Symptoms ◽  
Prolonged Exposure Therapy ◽  
History Of ◽  
Nonepileptic Seizures

Psychogenic nonepileptic seizures (PNES) superficially resemble epileptic seizures but are not associated with epileptic discharges in the brain. Instead, these episodes, which tend to occur with alterations in consciousness and body movements, are thought to be the result of mechanisms of conversion and dissociation. Psychological trauma and PTSD are very prevalent among patients with PNES. PNES can be conceived of as an extreme avoidance mechanism that serves the function of modulating distress and, in some cases, eliminating the precipitant stressor. Avoidance is also an essential component of PTSD. In patients who carry a dual diagnosis of PNES and PTSD, it is sensible that an empirically validated treatment for PTSD such as prolonged exposure (PE) therapy which targets avoidance by promoting exposure might be a useful approach to treat these patients. In this report, we present the case of a 52-year-old male with a 7-year history of PNES. His seizures, which were characterized by intense body shaking and loud guttural outbursts, were occurring up to 15 times per day. Because of these symptoms, he lost his employment and was ostracized by his family. Upon completion of a course of intensive outpatient PE, he achieved full remission of all psychogenic symptoms. Except for three brief seizures, he has maintained his health for 2 years. This constitutes the first detailed report of PE therapy used to effectively treat comorbid PNES and posttraumatic stress symptoms.

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