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Curr Neurol Neurosci Rep. 2017 Sep;17(9):71. doi: 10.1007/s11910-017-0781-7.

Psychogenic Non-Epileptic Seizures.

Author information

1
Department of Neurology, Baylor College of Medicine, Houston, TX, 77030, USA.
2
Neurophysiology Services, Michael E. DeBakey VA Medical Center, Houston, TX, 77030, USA.
3
School of Public Health, Washington University in St. Louis, 113 River Bridge Lane, Apt 103, Memphis, TN, 38103, USA.
4
Departments of Psychiatry and Neurology, Brown University, Providence, RI, 02903, USA. william_lafrance_jr@brown.edu.
5
Neuropsychiatry and Behavioral Neurology, Rhode Island Hospital, 593 Eddy Street, Potter 3, Providence, RI, 02903, USA. william_lafrance_jr@brown.edu.

Abstract

PURPOSE OF REVIEW:

In this review, we elucidate the evaluation process involved in the diagnosis of psychogenic non-epileptic seizures (PNES). Minimum clinical criteria required to attain this diagnosis via a staged approach are delineated. The psychological underpinnings and management of PNES from the neurologists' perspective are also explored.

RECENT FINDINGS:

Helpful clues can be deduced from history-taking, seizure semiology, ictal/peri-ictal physical exam, and ictal/inter-ictal EEG data. No single clinical data point is definitively diagnostic of PNES. Instead, the level of certainty for PNES diagnosis is contingent upon concordance of the composite clinical evidence available. Robust neurologist-patient alliance not only facilitates the evaluation process but can influence therapeutic impact. While diagnosis of PNES can be challenging, this diagnosis can be reliably made upon establishing concordance of the historical, physical exam, and video-EEG findings. Evidence-based treatments are available for patients with PNES. Continued efforts remain necessary to enhance timely diagnosis and interdisciplinary management for patients with PNES.

KEYWORDS:

Conversion disorder; Differential diagnosis; Functional neurologic disorders; Psychogenic non-epileptic seizures; Treatment; Video EEG

PMID:
28770498
DOI:
10.1007/s11910-017-0781-7
[Indexed for MEDLINE]

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