Psychogenic nonepileptic seizure

Revision as of 19:58, 1 June 2018 by Clonro01 (talk | contribs) (Management)

Background

Clinical Features

Differential Diagnosis

Differential diagnosis of seizures

Seizure

Evaluation

Management

  • Avoid invasive medical procedures
  • Some patients will improve after they are told the diagnosis in a compassionate, non-jugdemental fashion.
  • If new diagnosis or diagnostic uncertainty consider admission for neurology consult and video EEG.
  • Psychiatric intervention is the main treatment modality for PNES. (e.g. outpatient cognitive behavioral therapy (CBT)).
    • The purpose of psychiatric consultation is to identify underlying psychiatric conditions that can help direct treatment.

Disposition

  • If symptoms improve consider discharge with close neurology and psychiatry follow-up to rule out epilepsy and identify and treat the underlying psychiatric origin of symptoms.
  • If symptoms cannot be controlled or patient/family are not accepting of diagnosis. Consider admission for observation and further evaluation.
  • Prognosis:
    • 25-38 percent of patients achieve seizure freedom
    • Children have a better prognosis than adults, with 70 to 80 percent achieving seizure remission

See Also

External Links

References