1,048 results match your criteria Seizures Psychogenic Nonepileptic


Hypermobility in patients with functional seizures: Toward a pathobiological understanding of complex conditions.

Epilepsy Behav 2022 May 14;132:108710. Epub 2022 May 14.

Neurosciences Research Centre, St George's University of London, London, UK; Atkinson Morley Regional Neuroscience Centre, St George's Hospital, London, UK; Department of Clinical and Experimental Epilepsy, Institute of Neurology, UCL, National Hospital for Neurology and Neurosurgery, UCLH, Epilepsy Society, UK. Electronic address:

Background: Functional seizures (FS), otherwise known as psychogenic nonepileptic seizures (PNES), are a common symptom presenting to neurology and epilepsy clinics. There is a pressing need for further research to understand the neurobiology of FS to develop mechanistically targeted treatments. Joint hypermobility is an expression of variation in connective tissue structure along a spectrum, and it has received increasing attention in functional neurological disorders, but there is lack of evidence of its relevance in FS. Read More

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Profiles of indigenous patients with epilepsy in a Brazilian village.

Epilepsy Behav 2022 Jun 5;131(Pt A):108703. Epub 2022 May 5.

Department of Neuroscience and Behavioral Science, Division of Neurology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

Introduction: Identifying epilepsy in local indigenous populations and describing its epidemiological, etiological, electroencephalographic, and therapeutic aspects can assist public health policies planning toward epilepsy in indigenous communities.

Methods: This descriptive, cross-sectional study investigated epilepsy among indigenous people residing in Jaguapirú Village, Dourados, Mato Grosso do Sul, Brazil. Participants had their clinical histories reviewed and physical examination performed, as well as one or more electroencephalograms (EEG) registered. Read More

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Diagnostic delay in functional seizures is associated with abnormal processing of facial emotions.

Epilepsy Behav 2022 Jun 5;131(Pt A):108712. Epub 2022 May 5.

VA RR&D Center for Neurorestoration & Neurotechnology, VA Providence Healthcare System, Providence, RI, USA; Dept of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.

Purpose: In patients with functional seizures (FS), delay in diagnosis (DD) may negatively affect outcomes. Altered brain responses to emotional stimuli have been shown in adults with FS. We hypothesized that DD would be associated with differential fMRI activation in emotion processing circuits. Read More

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EEG and MRI Abnormalities in Patients With Psychogenic Nonepileptic Seizures.

J Clin Neurophysiol 2022 Apr 28. Epub 2022 Apr 28.

Department of Clinical Neurological Sciences, Western University, London, ON, Canada.

Objective: To compare the rate of EEG and MRI abnormalities in psychogenic nonepileptic seizures (PNES) patients with and without suspected epilepsy. Patients were also compared in terms of their demographic and clinical profiles.

Methods: A retrospective analysis of 271 newly diagnosed PNES patients admitted to the epilepsy monitoring unit between May 2000 and April 2008, with follow-up clinical data collected until September 2015. Read More

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Exploring the influence of telehealth on patient engagement with a multidisciplinary Non-Epileptic Seizure (NES) Clinic during the COVID-19 pandemic.

Epilepsy Behav 2022 Jun 21;131(Pt A):108707. Epub 2022 Apr 21.

Department of Neurology, University of Colorado, Aurora, CO, USA.

The ILAE task force has identified a gap in treatment access for patients with nonepileptic seizures (NES) [1]. Access to multidisciplinary treatment clinics for adults with NES is limited with only 18 institutions delivering care across the United States [2]. Patient engagement has been low in the University of Colorado, NES Clinic treatment program despite our clinic's status as the only clinic of its kind in the mountain west. Read More

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Psychogenic nonepileptic seizure: A neurologist's perspective.

Authors:
Elaine Wyllie

Cleve Clin J Med 2022 05 2;89(5):260-261. Epub 2022 May 2.

Epilepsy Center, Cleveland Clinic; Professor of Neurology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH

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Psychogenic nonepileptic seizure: An empathetic, practical approach.

Cleve Clin J Med 2022 05 2;89(5):252-259. Epub 2022 May 2.

Department of Neurology, Cleveland Clinic; Associate Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH

Psychogenic nonepileptic seizure (PNES) is often misdiagnosed as epilepsy, leading to unnecessary treatments and procedures, as well as failure to engage patients in needed mental health care. To establish an accurate diagnosis, video electroencephalography (EEG) in the context of and simultaneous with a comprehensive neurologic and psychosocial evaluation is recommended for any patient with seizures that are not responding to treatment. Delivering the diagnosis with empathy and respect is a crucial component of care that helps patients establish trust with caregivers and follow treatment recommendations. Read More

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Epilepsy and Diagnostic Dilemmas: The Role of Language and Speech-Related Seizures.

J Pers Med 2022 Apr 18;12(4). Epub 2022 Apr 18.

Department of Medical Oncology, Medway NHS Foundation Trust, Windmill Road, Gillingham ME7 5NY, UK.

Although the impact of epilepsy on expressive language is heavily discussed, researched, and scientifically grounded, a limited volume of research points in the opposite direction. What about the causal relationship between disorder-related language activities and epileptic seizures? What are the possible diagnostic dilemmas that experts in the field of speech-language pathology, neurology, and related fields face? How far has research gone in investigating psychogenic nonepileptic seizures, the misdiagnosis of which can be a thorny issue for clinicians and a detrimental factor for the patients' health? In order to address these questions, the study at hand focuses on a common, ever-intensified (by the COVID-19 pandemic) speech disorder-stuttering, and explores the pathophysiological and psychogenic background of the phenomenon. It also looks at the role of stuttering as a contributing factor to the appearance of epileptic seizures, in the hope of drawing attention to the complexity and importance of precise detection of stuttering-induced epilepsy, as a specific subcategory of language-induced epilepsy. Read More

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Psychogenic Nonepileptic Seizures in Children and Adolescents.

Authors:
Dara Vf Albert

Semin Pediatr Neurol 2022 Apr 16;41:100949. Epub 2021 Dec 16.

Nationwide Children's Hospital/The Ohio State University, Department of Pediatrics, Division of Neurology, Columbus, OH. Electronic address:

Psychogenic nonepileptic seizures (PNES) are a common condition seen in children and adolescents. The diagnosis is clinical, based on a description of events, and can be supported using video electroencephalography recording. Children and adolescents with PNES often have comorbid psychiatric conditions and psychosocial stressors, although this is not a requisite for diagnosis. Read More

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Furthering the Evidence of Comorbid Psychiatric Disorders in Pediatric Patients With Psychogenic Nonepileptic Seizures.

Authors:
Charuta Joshi

Epilepsy Curr 2022 Mar-Apr;22(2):114-116. Epub 2021 Oct 31.

Children's Hospital Colorado Department of Neurology, Aurora, USA.

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October 2021

Sense of control, selective attention and cognitive inhibition in pediatric functional seizures: A prospective case-control study.

Seizure 2022 May 30;98:79-86. Epub 2022 Mar 30.

Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, United States. Electronic address:

Purpose: To date, laboratory-based experimental behavioral methods have not been used to identify factors associated with pediatric functional seizures (FS), leaving a critical gap for effective treatment development.

Methods: Children ages 13-18 with video-EEG-confirmed FS were matched to controls (MCs) based on income, sex, race, and age. A modified Stroop task which included a condition requiring participants to report the ink colors in which seizure symptom words were written (e. Read More

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Functional neurological disorder: new subtypes and shared mechanisms.

Lancet Neurol 2022 Jun 14;21(6):537-550. Epub 2022 Apr 14.

Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Functional neurological disorder is common in neurological practice. A new approach to the positive diagnosis of this disorder focuses on recognisable patterns of genuinely experienced symptoms and signs that show variability within the same task and between different tasks over time. Psychological stressors are common risk factors for functional neurological disorder, but are often absent. Read More

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Identification of risk factors and distinguishing psychogenic nonepileptic seizures from epilepsy: A retrospective case-control study.

Clin Neurol Neurosurg 2022 Jun 31;217:107221. Epub 2022 Mar 31.

University of Hawai'i at Mānoa, John A. Burns School of Medicine, Honolulu, HI USA; University of California, Davis, School of Medicine, Department of Neurological Surgery, Sacramento, CA, USA. Electronic address:

Introduction: Patients with psychogenic non-epileptic seizures (PNES) experience significant morbidity and early mortality, secondary to delayed diagnosis. Better characterizing risk factors and exploring how PNES differentially affects sex and racial strata may facilitate earlier diagnosis.

Methods: From a Hawai'i neuroscience institution, 101 PNES patients were investigated in relation to sociodemographic and medical comorbidities. Read More

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Psychogenic nonepileptic seizures: clinical characteristics and outcome.

Brain Behav 2022 May 12;12(5):e2567. Epub 2022 Apr 12.

Epilepsy Center, Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.

Background: Clinical characteristics, outpatient situation, and outcome in patients with psychogenic nonepileptic seizures (PNES) remain to be elucidated.

Methods: Patients diagnosed with PNES after video-electroencephalography (EEG) monitoring (VEM) 03/2000-01/2016 at the Erlangen Epilepsy Center were surveyed between June 2016 and February 2017. Primary outcome was PNES cessation defined as no PNES episodes within > = 12 months prior to the interview. Read More

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T-wave heterogeneity crescendo in the surface EKG is superior to heart rate acceleration for seizure prediction.

Epilepsy Behav 2022 May 31;130:108670. Epub 2022 Mar 31.

Department of Neurology, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, United States; Harvard Medical School, 99 Brookline Avenue, RN-301, Boston, MA 02215, United States; Massachusetts General Hospital, Boston, MA, United States; Consortia for Improving Medicine with Innovation & Technology (CIMIT), 125 Nashua St., Suite 324, Boston, MA 02114, United States. Electronic address:

We examined whether T-wave heterogeneity (TWH) on the surface electrocardiographic (EKG) could predict epileptic seizure onset. Patients with electroencephalography-confirmed generalized tonic-clonic seizures (GTCS) (n = 6) exhibited abnormal elevations in TWH (>80 µV) at baseline (105 ± 20.4 µV), which increased from 30 min prior to seizure without heart rate increases > 2 beats/min until 10 min pre-seizure. Read More

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Pseudoresistance in idiopathic/genetic generalized epilepsies - Definitions, risk factors, and outcome.

Epilepsy Behav 2022 May 17;130:108633. Epub 2022 Mar 17.

Department of Neurology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark; OPEN, Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark. Electronic address:

Objective: The aim of the study was to determine risk factors associated with pseudoresistance in a large, representative cohort of patients with Idiopathic/Genetic Generalized Epilepsy (IGE) and the impact of pseudoresistance on socioeconomic parameters.

Methods: We performed a literature review on definitions of pseudoresistance in IGE. In an established cohort of patients with IGE from Funen, patients with current or previous pseudoresistant seizures were retrospectively identified based on a comprehensive evaluation of the patients' medical records and direct patient contact, if required. Read More

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Nonepileptic attacks in patients with brain tumor-related epilepsy.

Epilepsy Behav 2022 Apr 16;129:108656. Epub 2022 Mar 16.

Department of Neurology, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, United Kingdom.

Epileptic seizures are well recognized as a presenting symptom in patients with brain tumors, however much less is known about coexisting nonepileptic attack disorder (NEAD) in this population. Establishing a diagnosis of NEAD can be challenging, especially in those with concomitant epilepsy. Nonepileptic attack disorder is associated with a high rate of morbidity, often due to coexisting psychological factors which may require the input of multiple services. Read More

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Psychogenic nonepileptic seizures: Are they a freeze reaction?

Epilepsy Behav 2022 Apr 14;129:108655. Epub 2022 Mar 14.

Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel; Department of Neurology, Rambam Health Care Campus, Haifa, Israel. Electronic address:

Psychogenic nonepileptic seizures (PNES) clinically resemble epileptic seizures (ES) but lack epileptic activity at the time of the seizure and are also not due to any other pathophysiological disorder. The integrative cognitive model (ICM) suggests that PNES is an automatic reaction generated from distorted memory and is perceived as uncontrollable and unwanted. Furthermore, the ICM model implies that a PNES event occurs due to an external or internal cue. Read More

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Neurology residents' education in functional seizures.

Epilepsy Behav Rep 2022 16;18:100517. Epub 2021 Dec 16.

Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

We report a survey of neurology residency program directors (PDs) and recent neurology residency graduates about the education provided during residency on functional seizures (FS), a subtype of functional neurological disorder (FND). The purpose of our study was to assess the education gap for neurology residents about FS since patients with FS are frequently seen by neurologists, who typically conduct the evaluation and share the findings with the patient. A survey was sent to 93 Neurology residency program directors and 71 recent graduates. Read More

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December 2021

Brief Report: Psychogenic Nonepileptic Events in Pediatric Patients with Autism or Intellectual Disability.

J Autism Dev Disord 2022 Feb 25. Epub 2022 Feb 25.

Division of Child Neurology, Nationwide Children's Hospital, Columbus, OH, USA.

This is a retrospective case series of pediatric patients referred to the psychogenic nonepileptic events clinic (PNEE) who had comorbid diagnoses of autism spectrum disorder (ASD) or intellectual disability (ID). We describe 15 patients, nine with ASD and six with ID who had a telephone visit follow-up at 12 months. There were higher rates of male gender (40%) and comorbid epilepsy (53%) compared to the larger PNEE cohort. Read More

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February 2022

Dissociation, Stressors, and Coping in Patients of Psychogenic Nonepileptic Seizures.

Indian J Psychol Med 2021 Nov 2;43(6):479-484. Epub 2020 Nov 2.

Dept. of Psychiatry, Grant Govt Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India.

Background: Psychogenic nonepileptic seizures (PNES) commonly present both to neurologists and psychiatrists and include a wide range of psychopathology. In order to understand the demographics, dissociative experiences, stressful life events, abuse, and coping in these patients, this study was undertaken.

Methods: This was a cross-sectional, observational study. Read More

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November 2021

Randomized Trials of Psychotherapeutic Treatment for Psychogenic Seizures: Scoping Review.

Indian J Psychol Med 2021 Nov 25;43(6):469-472. Epub 2021 Oct 25.

Amity Institute of Psychology and Allied Sciences, Amity University, Sector 125, Noida, Uttar Pradesh, India.

Background: Psychotherapy improves seizure frequency and psychosocial aspects in psychogenic nonepileptic seizures (PNES). Although randomized controlled trials (RCTs) on different psychotherapies have been conducted for almost two decades now, no review has exclusively assessed RCTs of different psychotherapies.

Methods: The objective was to review RCTs of psychotherapy for PNES, to understand the impact of different psychotherapies. Read More

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November 2021

Functional movement disorder and functional seizures: What have we learned from different subtypes of functional neurological disorders?

Epilepsy Behav Rep 2022 26;18:100510. Epub 2021 Nov 26.

Northwestern University Feinberg School of Medicine, Department of Neurology, Chicago, IL, United States.

The objective of this paper is to compare and contrast FMD and FS, and highlight important differences in etiology and the clinical approach towards these two entities. While patients with FMD often experience abnormal movements on a daily basis, FS is characterized by paroxysmal events. Both patient populations share psychiatric and environmental comorbidities, but patients with FS may have increased anxiety and neuroticism and a higher percentage of childhood trauma. Read More

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November 2021

Uses and abuses of the neuropsychological assessment in the presurgical evaluation of epilepsy surgery candidates.

Epilepsy Behav Rep 2022 23;18:100507. Epub 2021 Nov 23.

Department of Psychiatry/Division of Neuropsychology, University College London, London, UK.

Recent guidelines from the International League Against Epilepsy (ILAE) delineating the role of the neuropsychologist in the assessment of epilepsy surgery patients stress the collaborative contribution neuropsychologists should make to seizure characterization, lateralization and localization in the pre-surgical setting. The role they should play in the comprehensive counselling of surgical candidates, including exploration of the patient's expectations of surgical treatment is also mandated. In this paper we present two contrasting case studies which illustrate the importance of these roles and the impact they can have on patient outcomes. Read More

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November 2021

A new biomarker in the differential diagnosis of epileptic seizure: Neurogranin.

Am J Emerg Med 2022 Apr 6;54:147-150. Epub 2022 Feb 6.

University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Department of Emergency Medicine, Istanbul, Turkey.

Aim: The aim of this study was to determine the level of serum NGRN in epilepsy patients presenting at the Emergency Department with complaints of an epileptic seizure, and to thus evaluate the utility of this biomarker in the differentiation of epilepsy and PNES patients from each other.

Material Methods: The study included patients aged >18 years who had experienced an epileptic seizure or were experiencing an epileptic seizure proven with EEG. All patients with brain disease of structural or infectious cause were excluded from the study (dementia, stroke, intracranial mass, meningitis, encephalitis, Creutzfeldt-Jacobs disease, abscess, etc). Read More

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Quality of Life in Psychogenic Nonepileptic Seizures: An Evolutionary Concept Analysis.

Issues Ment Health Nurs 2022 Feb 11:1-7. Epub 2022 Feb 11.

College of Nursing, University of Tennessee Knoxville, Knoxville, Tennessee, USA.

Psychogenic nonepileptic seizures (PNES) pose a serious threat to quality of life (QOL) in patients who battle the disorder. As psychological treatment options have progressed, improvement in QOL has become a more common desired outcome. Despite its relevance in PNES research and treatment, QOL has not been defined in the PNES population. Read More

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February 2022

Neuropsychological performance and effort in patients diagnosed with psychogenic nonepileptic seizures - Descriptive study of a Czech sample.

Epilepsy Behav 2022 03 4;128:108584. Epub 2022 Feb 4.

Epilepsy Center, Na Homolce Hospital, Prague, Czech Republic.

Purpose: The aim of the study was to examine the neuropsychological performance and effort in patients with a confirmed PNES diagnosis. The second aim of the study was to investigate the relationship between validity indicators from the cognitive battery with validity and clinical scales from a personality scale.

Method: Patients with PNES (N = 250; F:M 186:64; mean age 38. Read More

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Quality of life for patients with psychogenic nonepilepsy seizures in comparison with age- and gender-matched patients with epilepsy - Cross-sectional study.

Epilepsy Behav 2022 03 3;128:108539. Epub 2022 Feb 3.

Aichi Medical University, Dept. of Neuropsychiatry, Japan.

Aims: Patients with psychogenic nonepileptic seizures (PNES), and age- and gender-matched patients with epilepsy (PWE) who utilized an out-patient service were compared regarding quality of life (QoL) and self-reported symptoms of depression. Additionally, the impact of miscellaneous clinical variables including symptoms of depression on QoL in patients with PNES and PWE in real-world settings was assessed.

Subjects And Methods: Adult patients who had a diagnosis of definite or documented PNES based on LaFrance's criteria (PNES group, n = 62), or of epilepsy based on results of clinical and EEG procedures (Epilepsy group, n = 61) were enrolled. Read More

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Functional seizures are associated with cerebrovascular disease and functional stroke is more common in patients with functional seizures than epileptic seizures.

Epilepsy Behav 2022 03 3;128:108582. Epub 2022 Feb 3.

Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States; Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, United States.

Purpose: To characterize the relationship between functional seizures (FSe), cerebrovascular disease (CVD), and functional stroke.

Method: A retrospective case-control study of 189 patients at a single large tertiary medical center. We performed a manual chart review of medical records of patients with FSe or epileptic seizures (ES), who also had ICD code evidence of CVD. Read More

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