Indian Journal of Health and Wellbeing

Priyesh Kumar Singh ¹, Tara Singh ², I. L. Singh ², V. N. Mishra ³

Affiliations
1 Cognitive Science Laboratory, Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, IN
2 Department of Psychology, Banaras Hindu University, Varanasi, Uttar Pradesh, IN
3 Institute of Medical Sciences, Banaras Hindu University, Varanasi, Pradesh, IN

Abstract

Psychogenic non-epileptic seizures (PNES) are epilepsy like episodes which have an emotional rather than organic origin and thought to reflect emotional disturbance. Research on etiology of PNES suggests the role of multiple psychiatric and neurological factors. However, the psychopathology of PNES is poorly understood. Some studies have suggested a number of psychological disorders which has overlapping symptoms with PNES. Conversion disorder, anxiety, post-traumatic stress disorder (PTSD), and depression to name a few, are the common co-morbid condition with PNES. Present study aimed at examining and comparing various psychiatric problems among PNES, epileptic and healthy control. For this purpose 60 participants, PNES (n=20), epilepsy (n=20), and healthy control (n=20) were recruited from department of neurology of Sir Sunder Lal hospital. Participants were administered with Symptoms Checklist-90-R (SCL-90-R) and responses were obtained on three administrations, each with PNES, epileptic and healthy control separately. Results revealed statistically higher level of psychiatric problem among PNES individuals in comparison to epilepsy and healthy control. It was concluded that psychiatric problem are more prevalent among PNES patients and health professionals should consider the psychiatric dimension during diagnosis and treatment of PNES.

Keywords

Etiology, Seizures, Psychiatric Disorders, Epilepsy, Psychogenic Non-Epileptic Seizures.

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Priyesh Kumar Singh ¹, Tara Singh ¹, Vijay Nath Mishra ², Ranjeet Kumar Singh ²

Affiliations
1 Department of Psychology Banaras Hindu University, Varanasi, Uttar Pradesh, IN
2 Institute of Medical Science Banaras Hindu University, Varanasi, Uttar Pradesh, IN

Abstract

Psychogenic non-epileptic seizures (PNES) are episodes of altered movement, sensation or experience which are similar to epilepsy but caused by psychological process and not associated with abnormal discharges in the brain. Because of its somatic and psychiatric manifestation it neither falls in medical nor in mental health domain. Mostly, PNES are trequently misdiagnosed as epileptic seizures which risks patient's life. The global prevalence of PNES is estimated to about 2-33%/100,000 per year. Moreover, patient referred to epilepsy care unit of which 5 to 33% are PNES, 10 to 40% (PNES) of refractory seizures, among which mostly are women (75%) with age range of 20 to 30 years. Diagnosis of PNES is complicated by possible co-morbidity with epilepsy and other somatic co-morbidities like chronic pain, headache, sleep disturbances, asthma, obesity and other psychiatric disorders. The gold standard to diagnose patient of PNES is video-encephalography (V-EEG) although it has pitfalls. No single mechanism of event or contributing factor has been identified to be necessary to explain PNES, usually it is assumed as an unintentional manifestation of emotional distress which can be explained on the basis of neurophysiological, psychological and social base. Till now no accepted protocol for the treatment of PNES exists because of varied underlying mechanism that have triggered PNES and which do exist is not for long period and ditfers individually. The future suggested treatment intervention should include these three arms i.e. neurological, cognitive- behavioural andpsychopharmacological intervention.

Keywords

Etiology, Seizures, Psychiatric, Epilepsy.

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