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.


Episoder(1146)

Podcast 739: Perceptions of Dress

Podcast 739: Perceptions of Dress

Contributor: Aaron Lessen, MD Educational Pearls: Study examined patient perceptions of providers wearing traditional white coats,  fleece coats and soft-shell jackets Found that white coats were see...

20 Des 20213min

Podcast 738: Acute Mesenteric Ischemia

Podcast 738: Acute Mesenteric Ischemia

Contributor: Ian Gillman, PA-C Educational Pearls: Acute mesenteric ischemia is a condition where bowel loses blood supply from an acute occlusion of the mesenteric arteries A frequent sign is abdomi...

14 Des 20212min

Podcast 737: TBI Outcomes

Podcast 737: TBI Outcomes

Contributor: Aaron Lessen, MD Educational Pearls: Study evaluating patient outcomes after traumatic brain injury (TBI) over 1 year Trial followed patients with severe TBI (GCS 3-8) and moderate TBI (...

13 Des 20212min

Podcast 736: Seasonal Affective Disorder

Podcast 736: Seasonal Affective Disorder

Contributor: Adam Barkin, MD Educational Pearls: Seasonal Affective Disorder (SAD) a form of seasonal depression which can result in trouble sleeping, concentration difficulties, changes in appetite,...

7 Des 20213min

Podcast 735: End Tidal CO2 and BiPAP

Podcast 735: End Tidal CO2 and BiPAP

Contributor: Aaron Lessen, MD Educational Pearls: End tidal CO2 is accurate to 1-4 mmHg in intubated patient but use with those on positive pressure ventilation like BiPAP is unclear Study looked at ...

6 Des 20212min

Podcast 734: Push Dose Antibiotics

Podcast 734: Push Dose Antibiotics

Contributor: Aaron Lessen, MD Educational Pearls: Recent study at a hospital in Chicago with a shortage of normal saline decided to push IV ceftriaxone rather than the typical infusion of the antibio...

1 Des 20212min

Podcast 733: Nitric Oxide for COVID

Podcast 733: Nitric Oxide for COVID

Contributor: Nick Hatch, MD Educational Pearls: Inhaled nitric oxide or Flolan may be considered in COVID Flolan is a prostaglandin can be inhaled or given IV These medications are classically us...

30 Nov 20215min

Podcast 732: Organophosphate Toxicity

Podcast 732: Organophosphate Toxicity

Educational Pearls: Organophosphates affect the cholinergic system by inhibiting acetylcholinesterase affecting muscarinic and nicotinic receptors Symptoms include lacrimation, salivation, bronchocon...

23 Nov 20215min

Populært innen Vitenskap

fastlegen
rekommandert
jss
tingenes-tilstand
rss-rekommandert
villmarksliv
liberal-halvtime
sinnsyn
forskningno
rss-paradigmepodden
fjellsportpodden
nevropodden
rss-nysgjerrige-norge
diagnose
vett-og-vitenskap-med-gaute-einevoll
abid-nadia-skyld-og-skam
tidlose-historier
dekodet-2
smart-forklart
hva-er-greia-med