Psychogenic non-epileptic seizures

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Psychogenic non-epileptic seizures
ICD-10 F44.5
ICD-9 300.11, 780.39

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Psychogenic non-epileptic seizures are a manifestation or a form of conversion disorder.[1] They take many forms, and particularly can mimic any sort of epileptic seizure; they are distinguished from epilepsy only in that they are not associated with abnormal, rhythmic discharges of cortical neurons.[2] The condition is not benign; people have broken bones, crashed automobiles, bitten off parts of their tongue, and even died from injuries sustained during non-epileptic seizures.[citation needed]

An older term for these, pseudoseizures, should not be used. While it is correct that a non-epileptic seizure may resemble an epileptic seizure, pseudo can also connote "false, fraudulent, or pretending to be something that it is not." Non-epileptic seizures are not false, fraudulent, or produced under any sort of pretense.

Misdiagnosis

Confounding neurologists and other physicians, psychogenic non-epileptic seizures are frequently misdiagnosed as epilepsy; less frequently, the reverse is true. Misdiagnosis means that appropriate treatments are not received by the patient. In addition, the former misdiagnosis is dangerous because it can result in administration of unnecessary (and even potentially harmful) medication; the latter because a person with epilepsy is not correctly treated with medication that could help them. Statistics on the prevalence of these misdiagnoses are not available.

Inpatient hospitalization for long term video-EEG monitoring is a costly but effective way to distinguish them from epileptic seizures. They tend not to respond to anticonvulsant medications. Also, many persons with epilepsy experience non-epileptic seizures as well; finding evidence of one does not rule out the presence of the other.

Many physicians measure serum prolactin levels in patients who may have non-epileptic seizures, because serum levels of prolactin are often elevated just following an epileptic seizure, returning to normal within 15 minutes.[3][4] Still, a negative prolactin does not rule out epileptic seizures (Ahmad & Beckett 2004). Also, individuals with non-epileptic seizures may have elevated prolactin levels for other reasons, including intercurrent epilepsy and medication side effects.[citation needed]

Treatment

The patient with psychogenic non-epileptic seizures is sometimes found to give a history of childhood physical abuse or sexual abuse or other severe emotional trauma. (Betts, 1997.) Treatment based on insight-oriented techniques or exploring of abuse histories has not been found to be effective.

Instead, treatment with cognitive therapy or behavioral therapy is focused on concrete strategies to recognize the triggers of the seizures and use techniques to control them and eventually halt the onset.[5][6][7][8][9]

See also

Notes

References

  • Ahmad S, Beckett MW. Value of serum prolactin in the management of syncope. Emerg Med J 2004;21:e3. Fulltext. PMID 14988379.
  • Betts, T. "Chapter 265: Conversion Disorders." In Epilepsy, a Comprehensive Textbook, ed. Engel, J., and Pedley, T, Lippincott-Raven, Philadelphia, 1997.

External links

Cost Effectiveness of Psychogenic non-epileptic seizures

| group5 = Clinical Trials Involving Psychogenic non-epileptic seizures | list5 = Ongoing Trials on Psychogenic non-epileptic seizures at Clinical Trials.govTrial results on Psychogenic non-epileptic seizuresClinical Trials on Psychogenic non-epileptic seizures at Google


| group6 = Guidelines / Policies / Government Resources (FDA/CDC) Regarding Psychogenic non-epileptic seizures | list6 = US National Guidelines Clearinghouse on Psychogenic non-epileptic seizuresNICE Guidance on Psychogenic non-epileptic seizuresNHS PRODIGY GuidanceFDA on Psychogenic non-epileptic seizuresCDC on Psychogenic non-epileptic seizures


| group7 = Textbook Information on Psychogenic non-epileptic seizures | list7 = Books and Textbook Information on Psychogenic non-epileptic seizures


| group8 = Pharmacology Resources on Psychogenic non-epileptic seizures | list8 = AND (Dose)}} Dosing of Psychogenic non-epileptic seizuresAND (drug interactions)}} Drug interactions with Psychogenic non-epileptic seizuresAND (side effects)}} Side effects of Psychogenic non-epileptic seizuresAND (Allergy)}} Allergic reactions to Psychogenic non-epileptic seizuresAND (overdose)}} Overdose information on Psychogenic non-epileptic seizuresAND (carcinogenicity)}} Carcinogenicity information on Psychogenic non-epileptic seizuresAND (pregnancy)}} Psychogenic non-epileptic seizures in pregnancyAND (pharmacokinetics)}} Pharmacokinetics of Psychogenic non-epileptic seizures


| group9 = Genetics, Pharmacogenomics, and Proteinomics of Psychogenic non-epileptic seizures | list9 = AND (pharmacogenomics)}} Genetics of Psychogenic non-epileptic seizuresAND (pharmacogenomics)}} Pharmacogenomics of Psychogenic non-epileptic seizuresAND (proteomics)}} Proteomics of Psychogenic non-epileptic seizures


| group10 = Newstories on Psychogenic non-epileptic seizures | list10 = Psychogenic non-epileptic seizures in the newsBe alerted to news on Psychogenic non-epileptic seizuresNews trends on Psychogenic non-epileptic seizures


| group11 = Commentary on Psychogenic non-epileptic seizures | list11 = Blogs on Psychogenic non-epileptic seizures

| group12 = Patient Resources on Psychogenic non-epileptic seizures | list12 = Patient resources on Psychogenic non-epileptic seizuresDiscussion groups on Psychogenic non-epileptic seizuresPatient Handouts on Psychogenic non-epileptic seizuresDirections to Hospitals Treating Psychogenic non-epileptic seizuresRisk calculators and risk factors for Psychogenic non-epileptic seizures


| group13 = Healthcare Provider Resources on Psychogenic non-epileptic seizures | list13 = Symptoms of Psychogenic non-epileptic seizuresCauses & Risk Factors for Psychogenic non-epileptic seizuresDiagnostic studies for Psychogenic non-epileptic seizuresTreatment of Psychogenic non-epileptic seizures

| group14 = Continuing Medical Education (CME) Programs on Psychogenic non-epileptic seizures | list14 = CME Programs on Psychogenic non-epileptic seizures

| group15 = International Resources on Psychogenic non-epileptic seizures | list15 = Psychogenic non-epileptic seizures en EspanolPsychogenic non-epileptic seizures en Francais

| group16 = Business Resources on Psychogenic non-epileptic seizures | list16 = Psychogenic non-epileptic seizures in the MarketplacePatents on Psychogenic non-epileptic seizures

| group17 = Informatics Resources on Psychogenic non-epileptic seizures | list17 = List of terms related to Psychogenic non-epileptic seizures


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