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Nonepileptic seizures - subjective phenomena.

M Reuber1, G H Rawlings1

  • 1Academic Neurology Unit, University of Sheffield, Sheffield, UK.

Handbook of Clinical Neurology
|October 11, 2016
PubMed
Summary

Psychogenic nonepileptic seizures (PNES) are often misdiagnosed, but subjective experiences differ significantly from epileptic seizures. Understanding these patient-reported symptoms is crucial for effective PNES treatment and prognosis.

Keywords:
anxietyconversiondissociationdissociative seizurephenomenologypseudoseizurepsychogenicpsychogenic nonepileptic seizuresubjective experiencesymptoms

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Area of Science:

  • Neurology
  • Psychiatry
  • Psychology

Background:

  • Psychogenic nonepileptic seizures (PNES) are frequently misdiagnosed as epileptic seizures or syncope.
  • Limited research has focused on the subjective symptomatology of PNES, despite its classification as a mental disorder.
  • Existing research often prioritizes observable manifestations over patients' lived experiences.

Purpose of the Study:

  • To provide an overview of qualitative and quantitative studies on subjective symptoms in PNES.
  • To explore the scope and limitations of various research methodologies in studying PNES.
  • To analyze ictal, peri-ictal, and interictal symptoms, with a focus on consciousness impairment.

Main Methods:

  • Review of qualitative and quantitative studies.
  • Analysis of data from questionnaires, self-reports, and physiologic measures.
  • Inclusion of linguistic and neuropsychologic experimental findings.

Main Results:

  • PNES is a clinically heterogeneous condition with diverse subjective symptoms.
  • Impairment of consciousness is a key feature discussed in PNES.
  • Methodologies vary in their ability to capture the subjective experience of PNES.

Conclusions:

  • Subjective symptomatology is vital for understanding PNES heterogeneity.
  • Patient-reported symptoms significantly impact treatment engagement and formulation.
  • Further research into subjective experiences is needed for improved PNES prognosis.