Annals of Indian Academy of Neurology
REVIEW ARTICLE
Year
: 2006  |  Volume : 9  |  Issue : 2  |  Page : 60--71

The diagnosis and management of pseudoseizures or psychogenic non-epileptic events


Aline J.C Russell 
 Department of Clinical Neurophysiology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK

Correspondence Address:
Aline J.C Russell
Department of Clinical Neurophysiology, Institute of Neurological Sciences, Southern General Hospital, 1345 Govan Road, Glasgow, UK G51 4TF

Pseudoseizures or psychogenic non-epileptic seizures (PNES) are often misdiagnosed as epilepsy. This review discusses what is known about PNES, the importance of differentiating PNES from epileptic seizures (ES), avoiding iatrogenic harm and of identifying and managing the underling psychological stressors to optimise outcome. Clinical suspicion and careful history taking with witness accounts is mandatory. Supportive investigations including video-EEG (VEEG) and the utility of VEEG and provocation are discussed. Resources to diagnose and manage PNES are an issue for most countries and clinical expertise may also be lacking. VEEG is an expensive diagnostic tool and there is variable collaboration between neurology and psychiatry which will influence how patients are managed. Confounding this, is the lack of evidence for best practice in managing PNES. The prognosis for the majority of patients with PNES appears to be poor, despite a wider recognition of the problem. Well conducted studies are needed to test the different treatment options.


How to cite this article:
Russell AJ. The diagnosis and management of pseudoseizures or psychogenic non-epileptic events.Ann Indian Acad Neurol 2006;9:60-71


How to cite this URL:
Russell AJ. The diagnosis and management of pseudoseizures or psychogenic non-epileptic events. Ann Indian Acad Neurol [serial online] 2006 [cited 2020 Nov 24 ];9:60-71
Available from: https://www.annalsofian.org/article.asp?issn=0972-2327;year=2006;volume=9;issue=2;spage=60;epage=71;aulast=Russell;type=0