Podcast #314: Psychogenic nonepileptic seizures (PNES)

Podcast #314: Psychogenic nonepileptic seizures (PNES)

Author: Gretchen Hinson, M.D.

Educational Pearls:

  • PNES vs. epilepsy: postictal state is diagnostic of an epileptic seizure (sonorous respirations and/or confusion, lasting typically 20-30 minutes); Epileptiform seizures show decrease in convulsion frequency, but increase in convulsion amplitude while PNES convulsions demonstrate episodic convulsion amplitudes; and epileptiform seizures usually do not pause.
  • PNES is a form of conversion disorder and can be associated with underlying personality disorder; however there are patients with epilepsy that also can have PNES which complicates the diagnosis and treatment.
  • Patients that are malingering may have flailing movements and might talk during the episodes - both not typical of epileptic seizures or PNES.
  • Treatment for PNES is with psychotropic medications and psychotherapy as opposed to antiepileptic medications

References:

Avbersek, A; Sisodiya, S. (2010). Does the primary literature provide support for clinical signs used to distinguish psychogenic nonepileptic seizures from epileptic seizures?. Journal of neurology, neurosurgery, and psychiatry. 81(7):719-25.

Devinsky, O; Gazzola, D; LaFrance, W. Curt (2011). Differentiating between nonepileptic and epileptic seizures. Nature Reviews. Neurology. 7 (4): 210–220.

Lesser, RP. (2003). Treatment and Outcome of Psychogenic Nonepileptic Seizures. Epilepsy Currents. 3(6):198-200. doi:10.1046/j.1535-7597.2003.03601.x.

Pillaia, JA; Hautab SR. (2012). Patients with epilepsy and psychogenic non-epileptic seizures: An inpatient video-EEG monitoring study. Seizure. 21(1): 24-27.


Jaksot(1146)

Podcast 796: Fluid Amounts in Septic Shock

Podcast 796: Fluid Amounts in Septic Shock

Contributor: Aaron Lessen, MD Educational Pearls: Septic shock management has traditionally endorsed rapid fluid resuscitation and the administration of vasopressors Current guidelines are for patien...

11 Heinä 20223min

Podcast 795: Lithium Toxicity

Podcast 795: Lithium Toxicity

Contributor: Peter Bakes, MD Educational Pearls: Lithium remains a commonly used medication for treating bipolar disorder Lithium toxicity can be acute, acute-on-chronic, or chronic Measuring blood ...

5 Heinä 20224min

Podcast 793: Postintubation Sedation and Analgesia

Podcast 793: Postintubation Sedation and Analgesia

Contributor: Peter Bakes, MD Educational Pearls: When intubating a patient, it is important to consider what medications will be used for post-intubation sedation and analgesia The common non-benzodi...

27 Kesä 20226min

Podcast 792: Rectal Prolapse

Podcast 792: Rectal Prolapse

Contributor: Jarod Scott, MD Educational Pearls: Rectal prolapse is an evagination of the rectal tissue through the anal opening Factors that weaken the pelvic floor muscles increase the risk of rect...

21 Kesä 20224min

Podcast 791: Hyperglycemic Hyperosmolar State

Podcast 791: Hyperglycemic Hyperosmolar State

Contributor: Aaron Lessen, MD Educational Pearls: Hyperglycemic Hyperosmolar State (HHS) is less common than Diabetic Ketoacidosis (DKA) but is associated with a mortality rate up to 10 times greater...

20 Kesä 20223min

On the Streets #14: Trauma Activations in the Field

On the Streets #14: Trauma Activations in the Field

The Emergency Medical Minute is excited to announce that we our upcoming event, Palliative. Check out our event page for more information and to buy tickets: Palliative Eventbrite Page

15 Kesä 202218min

Podcast 790: Opioids vs OTC Pain Meds

Podcast 790: Opioids vs OTC Pain Meds

Contributor: Aaron Lessen, MD Educational Pearls: NSAIDs are a potential alternative to opioids for pain management and are associated with decreased rates of adverse effects A recent study evaluated...

14 Kesä 20223min

Podcast 789: DOAC

Podcast 789: DOAC

Contributor: Aaron Lessen, MD Educational Pearls: Direct Oral Anticoagulants (DOACs) have surpassed Warfarin and Lovenox® for anticoagulation as they do not require injection and allow for easier di...

13 Kesä 20223min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-poliisin-mieli
rss-mita-tulisi-tietaa
docemilia
rss-duodecim-lehti
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
utelias-mieli
radio-antro
rss-astetta-parempi-elama-podcast
rss-lapsuuden-rakentajat-podcast
rss-lihavuudesta-podcast
rss-sosiopodi