Indian Journal of Health and Wellbeing

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Psychogenic Non-Epileptic Seizures (PNES)


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

   Subscribe/Renew Journal


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.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Abubakar, A., Kablinger, A., & Caldito, A. (2003). Psychogenic seizures: Clinical features and psychological anstlysis.Epilepsy a-ndBehavior, 4, 241-245.

  • Alper, K. (1994). Nonepileptic seizures. Neorologic Clinic: Special Issue, 12,73-153.

  • Alper, K., Devinsky, O., Ferine, K., Vazquez, B., & Luciano, D. (1995). Psychiatric classification of non conversionnon epileptic seizures. Seizures, 51,99-201.

  • Barry, J. J., Witenberg, D., Bullock, K. D., Michaels, J. B., Classen, C. C., & Fisher, R.S. (2008). Group therapy for patient of psychogenic non epileptic seizures: Apilot study. Epilepsy and Behaviour, 13, 624-629.

  • Baslet, G. (2011). Psychogenic non epileptic seizures: A model of their pathogenic mechanism. Seizures, 20,1-13.

  • Betts, T., & Boden, S. (1992). Diagnosis, management and prognosis of a group of 128 patient with non epileptic attack disorder. Seizures, 1,19-26.

  • Brroks, J. L., Goodfellow, L., Bodde, N. M. G.,Aldenkamp, A., &Baker, G. A. (2007). Non drug treatment for psychogenic non epileptic seizures: what's the evidence. Epilepsy and Behaviour, 11, 367-377.

  • Cragar, D. E., Berry, P. T. R., Schmitt, F. A., & Fakhurry, T. A. (2002). Cluster analysis of normal personality trait in patient with non-epileptic Seizures.Seizures, 6,593-600.

  • Drane, D. L., Williason, D. J., Stroup, E.S., Holmes, M. D., Jung, M., Koemer, E., & Miller, J. W. (2006). Cognitive impairment is not equal in patient with epileptic and psychogenic nonepileptic seizures. Epilepsia 47, 1879-1886.

  • Ettinger, A. B., Devinsky, O., Wisbort, P. M., Ramkrishna, K. K., & Goyal, A. A. (1999). A comprehensive profile of clinical, psychiatric and psychosocial characteristics of patient with psychogenic non epileptic seizures. Epilepsia, 40,1292-1298.

  • Griffith, N. M., Smith, K. M., Schefft, B. K., Sazflarski, J. P., & Privitera, M. D. (2008). Optimisim, pessimism and neuropsychological performance across semilogy-based subtypes of psychogenic nonepileptic seizures. Epilepsy and Behavior, 75,478-484.

  • Hill, S. W., & Gale, S. D. (2011). Neuropsychological characteristics of nonepileptic seizure semiological subgroups. Epilepsy and Behavior, 22(2), 255-260. http://doi.org/10.1016/j.yebeh.2011.06.011.

  • James, M. R., Marshall, H., & CarewMcColl, M. S. (1991). Pulse oximetry during apparent tonic clonic seizures. Zawce?, H, 394-395.

  • Labate, A., Cerasa, A., Mula, M., Mumoli, L., Gioia, M. C., Aguglia, U., & Gambardella, A. (20I2).Neuroanatomic correlates of psychogenic nonepileptic seizures: A cortical thickness and VBM study. Epilepsia, 53(2), 377-385. http://doi.org/10.1111/j.l528- 1167.2011.03347.x

  • Lemper, T., Bauer, M., & Schmidt (1994). A videometric analysis of 56 episodes of transient cerebral hypoxia. Annals of Neurology, 36,233-237.

  • Lesser, R. P. (1996). Psychogenic seizures. Neurology, 46,499-507.

  • McDade, G., & Brown, S. W. (1992). Non epileptic seizures: Management and predictive factor of outcome. Seizures, 1, 7-10.

  • Meierkord, H., Will, B., Fish, D., & Shorvan, S. (1991). The clinical features and prognosis of pseudoseizures diagnoded using video EEG telemetry. ^Neurology, 41, 1643-1646.

  • Prigatano, G. P., & Kirlin, A. A. (2009). Self-appraisal and objective assessment of cognitive and affective functioning in person with epileptic and non epileptic SQizViSQS. Epilepsy a-ndBehavior, 14, 387-392.

  • Reuber, M., & Eiger, C. E. (2003). Psychogenic non epileptic seizures: Review and updaXQ. Epilepyy and Behavior, 4, 205-216.

  • Reuber, M. (2008). Psychogenic nonepileptic seizures: Answers and questions. Epilepsy andBehavior, 12, 622-635.

  • Rugg, F. J., Harrison, N. A., & Duncan, J. S. (1996). Evaluation of the accuracy of seizures description by the relative of patient with epilepsy. Epilepsy Research, 43, 193-199.

  • Swingle, P. G. (1998). Neuro-feedback treatment of pseudoseizures disorders. Biol Psychiatry, 44, 1196-1199.

  • Szaflarski, J. P., Ficker, D. M., Cahill, W. T., & Privitera, M. D. (2000). Four-year incidence of psychogenic nonepileptic seizures in adults in Hamilton county. Neurology, 55,1561-1563


Abstract Views: 209

PDF Views: 0




  • Psychogenic Non-Epileptic Seizures (PNES)

Abstract Views: 209  |  PDF Views: 0

Authors

Priyesh Kumar Singh
Department of Psychology Banaras Hindu University, Varanasi, Uttar Pradesh, India
Tara Singh
Department of Psychology Banaras Hindu University, Varanasi, Uttar Pradesh, India
Vijay Nath Mishra
Institute of Medical Science Banaras Hindu University, Varanasi, Uttar Pradesh, India
Ranjeet Kumar Singh
Institute of Medical Science Banaras Hindu University, Varanasi, Uttar Pradesh, India

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.

References