Wednesday, September 07, 2005

Psychogenic Nonepileptic Seizures

The 01 September 2005 issue of the journal American Family Physician has an overview directed toward general practitioners, internists, and family-practice docs on the topic of psychogenic nonepileptic seizures, explaining what they are, how they can be distinguished from epileptic seizure disorders, and treatment options.

The paper is available in full-text content: Psychogenic nonepileptic seizures by Taoufik M. Alsaadi and Anna Vinter Marquez. (American Family Physician 2005; 72: 849-856.)

Here is the abstract:
Psychogenic nonepileptic seizures are episodes of movement, sensation, or behaviors that are similar to epileptic seizures but do not have a neurologic origin; rather, they are somatic manifestations of psychologic distress. Patients with psychogenic nonepileptic seizures frequently are misdiagnosed and treated for epilepsy. Video-electroencephalography monitoring is preferred for diagnosis. From 5 to 10 percent of outpatient epilepsy patients and 20 to 40 percent of inpatient epilepsy patients have psychogenic nonepileptic seizures. These patients inevitably have comorbid psychiatric illnesses, most commonly depression, posttraumatic stress disorder, other dissociative and somatoform disorders, and personality pathology, especially borderline personality type. Many patients have a history of sexual or physical abuse. Between 75 and 85 percent of patients with psychogenic nonepileptic seizures are women. Psychogenic nonepileptic seizures typically begin in young adulthood. Treatment involves discontinuation of antiepileptic drugs in patients without concurrent epilepsy and referral for appropriate psychiatric care. More studies are needed to determine the best treatment modalities.
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Anthony H. Risser | |

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