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(1147)

Podcast 628: ST Elevation

Podcast 628: ST Elevation

Contributor: Peter Bakes, MD Educational Pearls: STEMI criteria is not just 1mm elevation in contiguous leads 1.5 mm in V2-V3 for women 2.0 mm in V2-V3 for men 2.5 mm in V2-V3 for men under 40 In...

5 Jan 20215min

Podcast 627: Oxygen Like It's Hot

Podcast 627: Oxygen Like It's Hot

Contributor: Aaron Lessen, MD Educational Pearls: High flow nasal cannula (HFNC) has become more utilized with COVID pandemic Multiple studies have shown this method improves both oxygenation and ven...

4 Jan 20213min

Pharmacy Phriday #6: Tik Tok Benadryl Challenge and Diphenhydramine Toxicity

Pharmacy Phriday #6: Tik Tok Benadryl Challenge and Diphenhydramine Toxicity

Contributor: Ruben Marrero-Vasquez, PharmD Educational Pearls: ACEP and FDA have both issued warnings about the viral Tik Tok Benadryl (diphenhydramine) challenge where individuals voluntarily overdo...

1 Jan 20216min

Mental Health Monthly #6: Suicide Assessment

Mental Health Monthly #6: Suicide Assessment

EMM is excited to welcome back the hosts of Millennial Mental Health Channel podcast to explain the key points of a robust suicide assessment in the ED. Dr. Justin Romano is a third year psychiatry re...

30 Des 202016min

Podcast 626: Updated Gonorrhea Treatment

Podcast 626: Updated Gonorrhea Treatment

Educational Pearls: The CDC has made new formal recommendations for treating Gonorrhea due to increasing resistance to Rocephin and Azithromycin. New recommendations: Confirmed gonorrhea: Ceftriaxo...

29 Des 20204min

Podcast 625: High Altitude Cerebral Edema (HACE)

Podcast 625: High Altitude Cerebral Edema (HACE)

Contributor: Tom Seibert, MD Educational Pearls: High altitude cerebral edema (HACE) is the end stage of acute mountain sickness and is diagnosed when patients develop neurologic dysfunction, ataxia,...

28 Des 20202min

Podcast 624: Timing and Tips on Sepsis

Podcast 624: Timing and Tips on Sepsis

Contributor: Don Stader, MD Educational Pearls: Time can be an important factor in outcomes regarding sepsis including mortality Emphasis has grown on early administration of antibiotics and IV fluid...

22 Des 20203min

Podcast 623: Acute Mountain Sickness

Podcast 623: Acute Mountain Sickness

Contributor: Tom Seibert, MD Educational Pearls: Acute Mountain sickness (AMS) can cause headache along with fatigue, nausea, vomiting, insomnia Typically occurs above 6500 feet (not 65,000) in eleva...

21 Des 20204min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
rss-paradigmepodden
forskningno
sinnsyn
fjellsportpodden
pod-britannia
rss-nysgjerrige-norge
tidlose-historier
hva-er-greia-med
rss-lundqvist-podden
dekodet-2
tomprat-med-gunnar-tjomlid
vett-og-vitenskap-med-gaute-einevoll
nordnorsk-historie