Working toward the ideal situation: A pragmatic Epi-Psy approach for the diagnosis and treatment of psychogenic nonepileptic seizures.

Epilepsy & Behavior : E&B
Coraline HingrayAlexis Tarrada

Abstract

Medical international guidelines recommend regular psychiatric consultations for patients with epilepsy, in order to detect comorbidities. However, there is a lack of guidance about PNES that constitute both a differential diagnosis and a comorbidity of epilepsy. While waiting for the ideal collaboration between neurologists and psychiatrists, we develop a pragmatic approach. Wrong diagnosis between epilepsy and Psychogenic nonepileptic seizures (PNES) is frequent and may lead to iatrogenic consequences for patients. To limit the risk of misdiagnosis, psychiatrists and neurologists should collaborate and be more trained about epilepsy, PNES, and their comorbidities. We illustrate the aim of this collaboration through the case of a patient, initially diagnosed with epilepsy, then with PNES only and finally with comorbid epilepsy and PNES. The correct final diagnosis would not have been performed without the collaboration of psychiatrists and neurologists, trained in "Epi-Psy" approach.

References

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Feb 1, 2003·Epilepsia·Jerzy P SzaflarskiMichael D Privitera
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Aug 18, 2009·Seizure : the Journal of the British Epilepsy Association·N M G BoddeA P Aldenkamp
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Oct 22, 2017·Seizure : the Journal of the British Epilepsy Association·Massimiliano BeghiEttore Beghi
Sep 22, 2018·Epilepsy & Behavior : E&B·Bertrand de ToffolKousuke Kanemoto
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Oct 28, 2019·Epilepsy & Behavior : E&B·Alexis TarradaBertrand de Toffol
Jul 14, 2020·Seizure : the Journal of the British Epilepsy Association·Mélanie FettigCoraline Hingray
Dec 1, 2020·Seizure : the Journal of the British Epilepsy Association·Marion GagnyCoraline Hingray
Jan 11, 2021·Epilepsy & Behavior : E&B·Louise GrenevaldCoraline Hingray

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