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(1145)

Episode 943: Portal Vein Thrombosis

Episode 943: Portal Vein Thrombosis

Contributor: Travis Barlock, MD Educational Pearls: What is Portal Vein Thrombosis? The formation of a blood clot within the portal vein, which carries blood from the gastrointestinal tract, pancrea...

10 Feb 20252min

Episode 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Episode 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Acute mountain sickness (AMS) is the term given to what is otherwise colloquially known as altitude sickness High altitude cerebral ed...

3 Feb 20253min

Episode 941: Rehydration in Pediatric Gastroenteritis

Episode 941: Rehydration in Pediatric Gastroenteritis

Contributor: Meghan Hurley, MD Educational Pearls: Gastroenteritis clinical diagnoses: Diarrhea with or without vomiting and fever Vomiting in the absence of diarrhea has a large list of diffe...

27 Jan 20253min

Episode 940: Laceration Repair Methods

Episode 940: Laceration Repair Methods

Contributor: Aaron Lessen, MD Educational Pearls: If a patient sustains a cut, the provider has several options on how to close the wound. If they choose to suture the wound closed, it involves need...

20 Jan 20252min

Episode 939: Serotonin Syndrome

Episode 939: Serotonin Syndrome

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Serotonin syndrome occurs most commonly due to the combination of monoamine oxidase inhibition with concomitant serotonergic medications...

13 Jan 20253min

Episode 938: AHA Policy on Management of Elevated Blood Pressure (BP) in the Acute Care Setting

Episode 938: AHA Policy on Management of Elevated Blood Pressure (BP) in the Acute Care Setting

Contributor: Aaron Lessen, MD Educational Pearls: Many patients present to the ED with elevated BP Many are referred from outpatient surgery centers or present after an elevated measurement at ho...

6 Jan 20252min

Episode 937: Pneumomediastinum

Episode 937: Pneumomediastinum

Contributor: Megan Hurley MD Educational Pearls: What is the mediastinum? The thoracic cavity is separated into different compartments by membranes The lungs exist in their own pleural cavities, a...

30 Des 20245min

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Episode 936: Etomidate vs. Ketamine for Rapid Sequence Intubation

Contributor: Ricky Dhaliwal MD Educational Pearls: Etomidate was previously the drug of choice for rapid sequence intubation (RSI) However, it carries a risk of adrenal insufficiency as an adver...

23 Des 20244min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
smart-forklart
vett-og-vitenskap-med-gaute-einevoll
rss-rekommandert
forskningno
sinnsyn
villmarksliv
fjellsportpodden
rss-nysgjerrige-norge
rss-paradigmepodden
pod-britannia
aldring-og-helse-podden
nordnorsk-historie
diagnose
tidlose-historier
tomprat-med-gunnar-tjomlid
rss-overskuddsliv