Updated Review on the Diagnosis and Primary Management of Psychogenic Nonepileptic Seizure Disorders.

Autor:	Lanzillotti AI; Buenos Aires University, Psychology School, Psychology School Research Institute National Council for Scientific and Technical Research (CONICET), Buenos Aires, Argentina., Sarudiansky M; Buenos Aires University, Psychology School, Psychology School Research Institute National Council for Scientific and Technical Research (CONICET), Buenos Aires, Argentina., Lombardi NR; Buenos Aires University, Ramos Mejía Hospital, Epilepsy Center, Buenos Aires, Argentina., Korman GP; Buenos Aires University, Psychology School, Psychology School Research Institute National Council for Scientific and Technical Research (CONICET), Buenos Aires, Argentina., D Alessio L; Buenos Aires University, Ramos Mejía Hospital, Epilepsy Center, Buenos Aires, Argentina.; Buenos Aires University, Medicine School, Cell Biology and Neuroscience Institute (IBCN)- National Council for Scientific and Technical Research (CONICET), Buenos Aires, Argentina.
Jazyk:	angličtina
Zdroj:	Neuropsychiatric disease and treatment [Neuropsychiatr Dis Treat] 2021 Jun 04; Vol. 17, pp. 1825-1838. Date of Electronic Publication: 2021 Jun 04 (Print Publication: 2021).
DOI:	10.2147/NDT.S286710
Abstrakt:	Psychogenic nonepileptic seizures (PNES) are paroxystic and episodic events associated with motor, sensory, mental or autonomic manifestations, which resemble epileptic seizures (ES), but are not caused by epileptogenic activity. PNES affect between 20% and 30% of patients attending at epilepsy centers and constitute a serious mental health problem. PNES are often underdiagnosed, undertreated and mistaken with epilepsy. PNES are diagnosed after medical causes (epilepsy, syncope, stroke, etc.) have been ruled out, and psychological mechanisms are involved in their genesis and perpetuation. For psychiatry, there is not a single definition for PNES; the DSM-IV and ICD-10/11 describe the conversion and dissociative disorders, and the DSM-5 describes the functional neurological disorders. However, patients with PNES also have a high frequency of other comorbidities like depression, particularly trauma and post-traumatic stress disorder. It has been postulated that PNES are essentially dissociations that operate as a defensive psychological mechanism that use the mind as a defense to deal with traumas. With the advent of VEEG in the 90s, the recognition of PNES has significantly increased, and several psychological treatments have been developed. In this manuscript, we carried out a state-of-the-art review, with the aim to provide a critical approach to the extensive literature about PNES, focusing on diagnostic aspects, the primary management, and the available treatments that have been shown to be effective for the improvement of PNES. Competing Interests: The authors reported no conflicts of interest for this work. (© 2021 Lanzillotti et al.)
Databáze:	MEDLINE
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