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Neurol Clin. 2009 Nov;27(4):909-924. doi: 10.1016/j.ncl.2009.06.004.

The etiology of psychogenic non-epileptic seizures: toward a biopsychosocial model.

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Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK. Electronic address:


Psychogenic non-epileptic seizures (PNES) are one of the most common differential diagnoses of epilepsy. PNES are poorly understood and often sub-optimally treated. This article summarizes current knowledge about the etiology of PNES. Through describing the interactions of predisposing, precipitating, perpetuating, and triggering factors, an integrated biopsychosocial model of a complex disorder is developed. PNES emerge as a dissociative response to a range of different stressors in vulnerable individuals. Once established, maintaining factors turn a temporary disturbance into a chronically disabling disorder.

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