A clinically oriented perspective on psychogenic nonepileptic seizure-related emergencies

Clinical EEG and Neuroscience
Barbara A DworetzkyGaston Baslet

Abstract

Psychogenic nonepileptic seizures (PNES) can present emergently and are often mistaken for epileptic seizures. PNES emergencies have not been well studied, and yet there are associated serious morbidities, particularly when patients are seen in an emergency setting and are misdiagnosed. PNES may be prolonged, mimicking status epilepticus, a condition we refer to as nonepileptic psychogenic status (NEPS), and patients may receive aggressive and unnecessary medical treatments that can lead to serious iatrogenic complications, including death. NEPS is also associated with an increased risk of self-harm, including suicide attempts, and may indicate a serious comorbid psychiatric illness. In addition to iatrogenic complications of PNES, accidents and injuries are an underrecognized source of morbidity. PNES may also present during medical procedures, which may not only interfere with their completion, but may alarm practitioners who, fearing liability, may initiate further medical evaluations and treatments. When PNES occur during pregnancy, patients may be misdiagnosed with eclampsia and their offspring delivered prematurely. They also risk being placed on medications that are harmful to the fetus. Increased awareness of PNES is ne...Continue Reading

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Citations

Sep 13, 2015·Seizure : the Journal of the British Epilepsy Association·Stoyan PopkirovJörg Wellmer
May 16, 2018·Herzschrittmachertherapie & Elektrophysiologie·Philipp S ReifFelix Rosenow
Aug 5, 2017·Neural Computation·Kiret DhindsaSuzanna Becker
May 5, 2020·Clinical EEG and Neuroscience·Kemal ArıkanNevzat Tarhan
May 11, 2021·Epilepsy & Behavior : E&B·Ahmed RadyAya Radwan

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