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This book is designed to fill the information gap and provide essential knowledge about PNES and the tools necessary to take charge of it.
Psychogenic nonepileptic seizures (PNES) are attacks that mimic epileptic seizures, but are not caused by abnormal electrical discharges in the brain. Instead, PNES are typically considered involuntary expressions of distress, making diagnosis and treatment a challenge. Historically, patients are referred to neurologists who, after completing a diagnostic work up, refer patients to mental health professionals, including psychiatrists, for treatment. For a number of reasons, this transition of care between specialists is often not successful, and this impacts patient treatment and outcomes. Psychogenic Nonepileptic Seizures: Toward the Integration of Care offers new insights into the practical diagnostic and treatment challenges faced by clinicians who manage this condition. This book covers the different stages of care, from the initial evaluation to long-term outcomes, and highlights the need to work collaboratively to provide patients with comprehensive care and improved outcomes. It provides up-to-date evidence and shares clinical expertise for the management of this challenging diagnosis that requires the expertise of a multi-disciplinary team. The authors provide a new framework on how to conceptualize and manage this disorder to more effectively address the needs of patients.
The primary aim of Treating Nonepileptic Seizures: Therapist Guide is to equip physicians, psychologists, therapists, nurses, and other practitioners with a validated, step-by-step treatment for psychogenic nonepileptic seizures (NES) that can improve the lives of patients with this disabling disorder. Patients with NES frequently present in neurology, psychiatry, psychology, and emergency departments. The disorder has been documented in the medical literature for centuries, and much is known about the phenomenology, seizure characteristics, psychiatric comorbidities, neuropsychological testing, and psychosocial aspects in NES. However, until recently, much less was known about the effective treatments of patients with psychogenic NES. This intervention provides guidance for clinicians in treating patients with NES and is designed to be used in conjunction with the patient workbook, Taking Control of Your Seizures. Session by session, the Workbook facilitates communication between treatment providers and individual patients with seizures. The authors' clinical experience with epilepsy and NES and research in developing the treatment approach for seizures directly informed the treatment model described. Many patients treated with the intervention have demonstrated improvements in seizures, symptoms, and quality of life.
Psychogenic Non-Epileptic Seizures (PNES) can cause blackouts, collapses, involuntary movements, loss of memory and have major impact on quality of life. Whereas epilepsy is caused by abnormal electrical activity in the brain, PNES are psychological-based responses to triggers inside or outside the body that are perceived as threatening by the person affected. PNES are poorly understood by the medical community. It is common for doctors to struggle to explain this diagnosis, which can leave their patients frustrated and confused. Often people are told that their PNES are caused by "stress" and sent away with no further support or advice. It is no wonder that those affected feel isolated, abandoned and hopeless about living with the condition. In Our Words: Personal Accounts of Living with Non-Epileptic Seizures shows those diagnosed with PNES that they are not alone, and how others have courageously managed to come to terms with their seizures. These heartfelt personal accounts will also allow family, friends, healthcare providers and researchers to gain more understanding of the condition and work to provide a better quality of life to those living with PNES.
Patients with nonepileptic seizures present in neurology, psychiatry, psychology and emergency departments. Although the disorder has been well documented in the medical literature and much is known about the nature and signs of the condition, much less has been written about its treatment and management. Gates and Rowan's Nonepileptic Seizures, third edition, takes a multidisciplinary approach to this neuropsychiatric disorder, building and branching from the prior editions, with a strong focus on management, to aid all clinicians in the diagnosis and treatment of both child and adult patients. With a DVD containing video material to supplement the differential diagnosis, patient characteristics and treatment sections, and with contributions from the leading authorities from around the world, this will be essential reading for physicians and psychologists, at all levels of training and experience, encountering patients with this complex brain-behavior disorder.
This book is a compilation of the experiences of people with psychogenic non-epileptic seizures (PNES). This psychological disorder has received little attention in the medical community and those experiencing PNES have often been misdiagnosed as having epilepsy. Some have been told that they are faking their seizures because their seizures do not register on standard tests for epilepsy. Non-epileptic seizures usually occur as a result of past trauma (PTSD) or stressful events which cannot be fully processed by the mind. It is our hope that the telling of our stories will give a voice to those who suffer with PNES and bring awareness to this disorder, educate medical professionals, families and friends of those with PNES and create a new level of compassion and understanding in order to bring about healing for PNES sufferers and all of those affected by this illness.
This volume describes the basics for short- and long-term treatment of Psychogenic Non-Epileptic Seizures (PNES) in children. The text acknowledges that the disorder, though rare and highly morbid, is treatable when it is not misdiagnosed. Given the limited diagnostic and clinical training offered to clinicians, this book aims to equip professionals with the tools needed to improve the poor quality of life of youth with PNES. The text begins by introducing the main features of the disorder and the problems involved in diagnosing PNES in children. It then describes techniques to overcome these problems in order to make a reliable and valid diagnosis of PNES, as well as provide feedback on the diagnosis and treatment plan. The last section describes the indications for cognitive behavior therapy for youth with PNES and suggested treatment paradigms. Incorporation of do’s and don’ts and their relevant clinical examples in all sections of the proposed guide provide the reader with skills and techniques. The book also includes an appendix with resources for parents, children, and school nurses and teachers, relaxation techniques for the child and parents, templates of letters for the child’s school about the condition and behavior management plan, templates of supporting letters from epileptologists and primary care physicians, CBT treatment paradigm, and information on individual supervision, workshops and webinars. Written by the few experts in this area, Pediatric Psychogenic Non-Epileptic Seizures is the ultimate guide for psychiatrists, psychologists, nurses, primary care physicians, neurologists, epileptologists, social workers, nurses, school counselors, and all medical professionals working with children experiencing seizures.
Many patients referred for an epilepsy evaluation actually suffer from one of many conditions that can imitate it. Imitators of epilepsy are a diverse group that involve consideration of many areas of internal medicine, neurology, and psychiatry. The most important imitators of epileptic seizures are dizziness, vertigo, syncope, complicated migraine; and somewhat less frequently sleep disorders, transient cerebral ischemia, paroxysmal movement disorders, endocrine or metabolic dysfunction, delirium, psychiatric conditions or transient global amnesia. Clearly under-recognized are hyperventilation episodes, panic attacks, and other psychogenic and psychiatric paroxysmal disorders that may simulate epileptic seizures. This volume provides a comprehensive review of the differential diagnosis of seizures: how do the imitators of epilepsy present clinically, what are their particular distinguishing historical features, and what tests are helpful with diagnosis? Expanding beyond the first edition, this second edition is divided into four sections. The first deals with an introduction and approach diagnosing spells, the electroencephalography of epilepsy and its imitators, and specialized tests of diagnosis such as measurement of serum prolactin. There are chapters on epileptic seizures that do not look like typical epileptic seizures, and conversely, apparent epileptic seizures that are not. A second section approaches imitators of epileptic seizures along age-based lines; i.e., what sorts of spells are likely to beset infants, children, or the elderly? A third section addresses individual imitators of epilepsy, ranging from the common to the rare, from dizziness and faintness to startle disease, arranged according to whether they might simulate partial, generalized, or both types of epileptic seizures. The volume finishes off with hyperventilation syndrome, psychogenic seizures (with or without epilepsy), and panic disorders. Most chapters review the basic definitions and physiology of the respective imitator, followed by the clinical characteristics. Emphasis is given to those features that may differentiate it from an epileptic event, but also mark it for what it is, and give possible criteria for an alternate diagnosis. Case vignettes are used to illustrate particular aspects, along with tables that compare and contrast phenotypically similar conditions. Based on their extensive clinical experience, the authors provide a personal perspective on diagnosis and treatment.
To an Outside Observer, Psychogenic Non-Epileptic Seizures (PNES) can look like epileptic seizures, However, unlike epileptic seizures, they are not caused by abnormal electrical discharges in the brain. Instead, most PNES are an automatic psychological and physiological response to an internal or external trigger perceived as threatening by the individual, whether consciously or not. Not least because the changes in the brain that underpin PNES cannot be visualized easily with clinical tests, there are many uncertainties and controversies surrounding the condition, and patients often provoke a mixture of emotions in healthcare professionals. While some patients have positive care experiences, many are left feeling confused, angry, and abandoned by the clinicians they have encountered. Non-Epileptic Seizures in Our Experience presents the perspectives of over 90 members of different healthcare professions from around the world. By allowing readers to gain fascinating insights into a broad range of their thoughts and feelings about PNES, this book challenges negative attitudes surrounding the condition and helps to improve understanding between members of different professional groups as well as between professionals and patients. In doing so, it should-ultimately-advance the quality of care provided for those with PNES. Book jacket.
Patients with nonepileptic seizures (NES) frequently present in neurology, psychiatry, psychology, and emergency departments. The disorder has been well-documented in the medical literature, and much is known about the phenomenology, ictal semiology, neurologic signs, psychiatric comorbidities, neuropsychological testing, and psychosocial aspects. Since the publication of the third edition in 2010, knowledge of treatments for NES has grown and new data have become available. Fully updated to reflect these developments, this fourth edition brings together the current knowledge of NES treatments, drawing on the experience of an international team of authors. An accompanying website features video-EEGs of seizures and videos of patient-clinician interactions, which will help readers with both diagnostic and management decisions. Tables clearly illustrating the differential diagnosis of various nonepileptic events give readers quick reference guides to aid diagnostic assessment. A valuable resource for neurologists, psychiatrists, psychologists, and any clinicians who encounter NES in their practice.