[Dissociative seizures: a manual for neurologists for communicating the diagnosis].

Der Nervenarzt
Kurt FritzscheA Schulze-Bonhage

Abstract

The great physical resemblance between epileptic and dissociative seizures and a diagnosis of epilepsy that had been made years ago and usually had been treated unsuccessfully makes it difficult for both physician and patient to communicate the diagnosis of dissociative seizures. A direct referral to psychotherapy treatment is rarely accepted by patients. Intermediate steps, which are based on cooperation between neurologists and psychotherapists, are necessary. The approach that we use to communicate diagnosis and motivation for psychotherapeutic treatment includes eight steps: 1. Welcome and introduction; 2. Jointly watching a video of documented seizures; 3. The message that the seizures are not of epileptic origin, 4. Development of an alternative disease concept; 5. Motivation for a conversation with a representative from psychosomatics; 6. Responding to the fear of "going crazy"; 7. If necessary, briefly touching on the subject of sexual violence; 8. More recommendations and conclusion of the conversation. The manual was discussed and practiced with the attending neurologist in two sessions and is now being regularly used by two neurologists with concomitant supervision.

References

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Mar 1, 2003·Epilepsy & Behavior : E&B·W Curt LaFrance, Orrin Devinsky
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Jun 18, 2003·Seizure : the Journal of the British Epilepsy Association·Simone CartonJohn S Duncan
Aug 6, 2003·Epilepsy & Behavior : E&B·Sarah Tomaszewski FariasTaoufik M Alsaadi
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Dec 15, 2004·Journal of Psychosomatic Research·Jon StoneMichael Sharpe
May 24, 2005·Epilepsy & Behavior : E&B·Dona E CragarToufic A Fakhoury
Jun 1, 2005·Perspectives in Psychiatric Care·Noreen C ThompsonEdward E Hunter
Aug 4, 2006·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Selim R Benbadis
May 1, 2007·Journal of Psychosomatic Research·Nynke M G BoddeAlbert P Aldenkamp
Dec 7, 2007·Epilepsy & Behavior : E&B·Cameron LaceyMichael Salzberg
Jan 1, 2008·Epilepsy & Behavior : E&B·Markus Reuber
Jan 24, 2009·Epilepsy & Behavior : E&B·Rebecca ThompsonMarkus Reuber
Dec 8, 2009·Seizure : the Journal of the British Epilepsy Association·Hilde Nordahl KarterudKarl Otto Nakken

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Citations

Dec 3, 2014·Seizure : the Journal of the British Epilepsy Association·Hilde Nordahl KarterudOle Rikard Haavet
Sep 6, 2017·Der Nervenarzt·A JoosA Schulze-Bonhage
May 15, 2013·Deutsches Ärzteblatt International·Kurt FritzscheAndreas Schulze-Bonhage

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