Pediatric stress-related seizures: conceptualization, evaluation, and treatment of nonepileptic seizures in children and adolescents

Current Opinion in Pediatrics
Beatrice L WoodBruce D Miller

Abstract

Nonepileptic seizures are seizure-like symptoms that occur in the absence of epileptogenic brain activity. They can cause severe compromise of daily function and impede development in children, and are frequently misdiagnosed, leading to inadequate or potentially harmful medical treatment. This review will characterize nonepileptic seizures, identify associated factors, propose to a reconceptualization of the phenomenon as stress-related seizures, and suggest guidelines for valid diagnosis and intervention. Nonepileptic seizures occur in 10 to 20% of children who present to epilepsy centers, and are more common in females. Early intervention improves prognosis. Factors associated are physical, sexual and other trauma, family dysfunction, and other acute or chronic stressors. They are frequently misdiagnosed and inappropriately treated. Therapy redirecting preoccupation with worries has been effective. Nonepileptic seizures are best conceptualized and referred to as stress-related seizures. Long Term Video-EEG Monitoring (LTM) is the gold standard for diagnosis. Diagnosis and intervention requires collaboration between primary care physicians, neurologists, and medically oriented clinicians providing individual and family psycho...Continue Reading

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Citations

Dec 5, 2008·Epilepsia·Marian Joëls
Aug 8, 2014·Molecular and Cellular Endocrinology·David CrewsMichael K Skinner
Apr 16, 2013·Pediatric Neurology·Lindsey A MorganJeffrey R Buchhalter
Dec 3, 2014·Seizure : the Journal of the British Epilepsy Association·Hilde Nordahl KarterudOle Rikard Haavet
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Mar 5, 2021·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Shirin Jamal OmidiSamden D Lhatoo

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