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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a prospective series of 18 patients with a diagnosis of non-epileptic seizures (NES, pseudoseizures) identified in one unit. Sixteen patients agreed to complete a therapeutic programme. At the end of treatment eight were seizure free, three had only occasional NES and five were unchanged. At 1-year follow-up the situation remained similar regarding seizures, with responders demonstrating an improvement in social functioning and a marked reduction in demands on health service resources. Admission variables significantly associated with a poor outcome were an IQ of less than 80 and a past history of violent behaviour.
Seizure 1992 Mar
PMID:Non-epileptic seizures: management and predictive factors of outcome. 134 23

A review of the literature on epileptic seizures (NES) is presented, a common clinical entity that can be reliably diagnosed if suggestion and video-EEG monitoring are combined with an appreciation of the phenomenology of epileptic and nonepileptic events. Axis I psychiatric disorders with symptoms such as anxiety or dissociation should be considered in the differential diagnosis of NES.
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PMID:Nonepileptic seizures. 818 8

This review highlights our understanding of episodic phenomena in children and adolescents that resemble epileptic seizures. Although the initial focus is on psychogenically determined nonepileptic seizures (NES; pseudoseizures), other forms of conversion symptoms are also discussed. We subsequently examine the diverse nonpsychogenic, nonepileptic paroxysmal disorders that may be encountered in this age group.
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PMID:Pseudoseizures and other nonepileptic paroxysmal disorders in children and adolescents. 1049 39

The term psychogenic pseudoepileptic seizures (or psychogenic non-epileptic seizures-NES) generally refers to episodes of psychological origin that resemble epilepsy but without underlying epilepsy. The diagnosis of pseudo-epileptic seizures is confirmed in 5-33% of patients that are considered to suffer from refractory epilepsies. Making a correct diagnosis in patients presenting with attack disorders is sometimes very difficult. However, the best way to establish differential diagnosis of epileptic and pseudoepileptic seizures is to apply long-term video EEG monitoring. Triggering a seizure by means of placebo administration or suggestion to start or stop seizure can be also a helpful method in differential diagnosis. Over the last decade epileptologist have been paying increasing attention to the Minnesota Multiphasic Personality Inventory (MMPI) scales in describing or distinguishing real epileptic seizures vs. non-epileptic attacks. The results of the study may have practical implications for neurological and epilepsy centres, and for improving clinical knowledge and allow to establish aetiological classification of psychogenic pseudoepileptic seizures.
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PMID:[Etiologic and diagnostic factors of psychogenic pseudo-epileptic seizures]. 1131 96

To explore the hypothesis that lateralized hemispheric dysfunction may contribute to the development of conversion symptoms, the authors studied frequency of unilateral cerebral physiological or structural abnormalities in 79 consecutive patients with conversion nonepileptic seizures (C-NES), who were also compared with two groups of epilepsy patients without C-NES. Sixty (76%) of the C-NES patients had unilateral cerebral abnormalities on neuroimaging, of which 85% were structural. Ictal or interictal epileptiform abnormalities on EEG were found in 78% of C-NES patients and focal slowing in another 10%. Fifty (63%) of the C-NES patients had both structural and epileptiform abnormalities. Among the 60 with unilateral abnormalities, 43 (71%) had right hemisphere structural lesions or physiologic dysfunctions (C-NES>non-C-NES, P<0.02). This study supports prior studies and clinical observations that cerebral dysfunction can contribute to the pathogenesis of conversion disorder, and that nondominant hemisphere dysfunction may play a greater role.
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PMID:Nondominant hemisphere lesions and conversion nonepileptic seizures. 1462 76

The purpose of this study was to examine the incidence of patients with NES vs. NES and concomitant epilepsy in an epilepsy centre and to present a diagnostic algorithm. We collected and reviewed the data of 322 patients consecutively referred to the adult ward of our epilepsy centre in 1 year. The results of our study reveal that 44 (14%) of all patients referred had NES. Of these, nine proved to have concomitant epilepsy. Of 44 patients with NES, 20 were treated with AED on admission. In 14 cases this unnecessary antiepileptic drug treatment was stopped. In six remaining patients with NES and concomitant epilepsy, the total number of AEDs could be reduced until discharge. The maximum duration of AED treatment among patients with NES only, had been longer than 360 months (median 72 months). Much has been written about whether the diagnosis of psychogenic non-epileptic events is overused. According to our experience however, the fact that many patients with so-called 'pharmacoresistant epilepsy', suspected NES or other diagnoses are referred to a centre of excellence much too late, proves to be the key problem in diagnosis and treatment of NES. We conclude that early admission of so-called 'pharmacoresistant epilepsy' to an epilepsy centre, establishing a standard work-up and clarifying the medical terminology will improve diagnosis and lead to adequate therapy of NES as well as prevent unnecessary drug treatment.
Seizure 2002 Mar
PMID:Improving diagnostic procedure and treatment in patients with non-epileptic seizures (NES). 1194 94

Despite the fact that clinical characteristics of frontal lobe seizures have been recently described better, differentiating seizures of frontal lobe origin from NES on clinical grounds alone is difficult. The difficulty has been compounded by the fact that both inter-ictal and ictal EEG can be normal or nonspecific, and the same is true of imaging studies. A detailed clinical history as well as video monitoring can be helpful diagnostic tools. A multidisciplinary approach is warranted and is at times essential to improve the diagnosis and care of these difficult patients.
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PMID:Frontal lobe seizures. 1612 71

Non-epileptic seizures have received a substantial amount of attention in the psychiatric and medical literature, but comparatively little attention from psychologists. Non-epileptic seizures resemble epileptic seizures but lack the physiological symptoms of genuine epilepsy and are psychological in origin. Many authors have emphasized the role that child sexual abuse may play in the etiology of this disorder. In the present paper, we provide a review of 34 studies examining this relationship, followed by a meta-analysis of 19 effect sizes. While our statistical results support the professed link between child sexual abuse and non-epileptic seizures, we suggest that because of research design limitations, it is premature to draw any definitive conclusions regarding a relationship. Eight of these research design limitations are identified and discussed (e.g., the absence of comparison groups; an explicit and public definition of child sexual abuse). Alternatives to a traditional psychoanalytic perspective that emphasizes the role of child sexual abuse in the etiology of NES are presented. Specific recommendations for future research are made and psychologists are strongly encouraged to play a more active role in both researching and treating non-epileptic seizures.
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PMID:Non-epileptic seizures and child sexual abuse: a critical review of the literature. 1647 97

Nonepileptic seizures are episodes that resemble seizures but are not epileptic. The importance of EEG in the diagnosis of NES is that misread (overread) EEGs are an important contributor to the misdiagnosis of epilepsy. About 20% to 30% of patients with refractory "seizures" seen at epilepsy centers have been misdiagnosed, and the vast majority have psychogenic nonepileptic seizures (PNES). Many such patients have had previous EEGs interpreted as epileptiform. These misdiagnoses based on EEG are easily perpetuated, complicate management, and adversely affect outcome. The reasons for the overinterpretation of EEGs include the common misconception that phase reversals indicate abnormalities and not applying strict criteria to make sharp transients epileptiform. The diagnosis of PNES typically begins with a clinical suspicion and then is confirmed with EEG-video monitoring. However, ictal EEG may be negative in some partial seizures and may be uninterpretable because of artifacts. Movements can generate rhythmic artifacts that mimic an electrographic seizure. Analysis of the ictal semiology (i.e., video) is at least as important as the ictal EEG. Provocative techniques, activation procedures, or "inductions" can also be useful for the diagnosis of PNES.
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PMID:The EEG in nonepileptic seizures. 1688 8

Subjective and objective assessments of cognitive and affective functioning of patients admitted to the EMU with epileptic (ES, n=22) and psychogenic nonepileptic (NES, n=23) seizures were compared. It was hypothesized that the patients with NES would overestimate their cognitive impairments and underestimate their affective disturbances relative to those with ES. Results revealed that the patients with NES reported greater word-finding difficulty than those with ES (P=0.02), but performed better than the patients with ES on the Boston Naming Test (BNT, P=0.03), suggesting a tendency to overestimate word-finding difficulty. Patients with NES and ES did not otherwise differ in subjective ratings of cognitive functions or emotional state; however, patients with NES performed worse on a test of affect expression/perception compared with those with ES (P=0.02). For patients with NES, only performance on memory tests was significantly correlated with their anxiety level. Obtaining both subjective ratings and objective test findings of cognitive and affective functioning may help further differentiate between patients with NES and those with ES.
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PMID:Self-appraisal and objective assessment of cognitive and affective functioning in persons with epileptic and nonepileptic seizures. 1912 38


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