Podcast 650: PNES

Podcast 650: PNES

Contributor: Katie Sprinkel, MD

Educational Pearls:

  • Psychogenic Non-Epileptic Seizures (PNES) are due to a psychogenic rather than an epileptic cause
  • Despite common assumption, PNES are not always volitional
  • 20-40% of those with PNES can also have true epileptic seizures 20-40%
  • True diagnosis requires a video EEG
  • Characteristics of PNES include:
    • Waxing and waning of the seizure intensity
    • Eyes clenched shut
    • Pelvic thrusting, rolling from side-to-side
    • Ability to respond to verbal stimuli during the seizure
    • Ability to recall information during the seizure
    • Weeping or stuttering
    • Guarding the face on passive hand drop
  • Characteristics of epileptic seizures:
    • Tongue biting
    • Prolonged postictal state
    • Incontinence
  • Haldol or Zyprexa may be better for PNES and benzodiazepines tend to be better for epileptic seizures

References

Huff JS, Murr N. Psychogenic Nonepileptic Seizures. 2021 Jan 28. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 28722901.

Asadi-Pooya AA. Psychogenic nonepileptic seizures: a concise review. Neurol Sci. 2017 Jun;38(6):935-940. doi: 10.1007/s10072-017-2887-8. Epub 2017 Mar 8. PMID: 28275874.

Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD



Episoder(1146)

Podcast 672: Oxygen Things

Podcast 672: Oxygen Things

Contributor: Aaron Lessen , MD Educational Pearls: Patients on 10L or more of oxygen per minute in the ICU were randomized to oxygen goals of 90% or 96% to compare 90-day mortality rates Mortality ra...

18 Mai 20212min

Podcast 671: Scapula Fractures

Podcast 671: Scapula Fractures

Contributor: Adam Barkin, MD Educational Pearls: Represents less than 1% of all fractures that occur, although it has a significant mortality rate of 2-5% Typically occurs in high-energy trauma and ...

17 Mai 20213min

Podcast 670: Operation Tat-Type

Podcast 670: Operation Tat-Type

Contributor: Dave Rosenberg, MD Educational Pearls: In 1951, Operation Tat-Type began tattooing adults with their blood type in an effort to prepare for rapid transfusions in the time of the Cold Wa...

12 Mai 20214min

Podcast 669: VTach Storm

Podcast 669: VTach Storm

Contributor: Gretchen Hinson, MD Educational Pearls: Three episodes of ventricular tachycardia within 24 hours or two episodes back-to-back Treat with IV amiodarone and IV beta-blockers initially as...

11 Mai 20215min

Podcast 668: Opioid-Induced Hyperalgesia

Podcast 668: Opioid-Induced Hyperalgesia

Contributor: Donald Stader, MD Educational Pearls: Opioids target kappa and NMDA receptors that can lead to central nervous system sensitization and therefore increased pain For patients with opioid-...

10 Mai 20214min

Podcast 667: Lactated Ringers for DKA

Podcast 667: Lactated Ringers for DKA

Contributor: Aaron Lessen, MD Educational Pearls: Recent study looked at whether lactated ringers might be a better choice for fluid resuscitation in patients with DKA compared to normal saline Norm...

4 Mai 20213min

Podcast 666: Pain Management & Patient Perspective

Podcast 666: Pain Management & Patient Perspective

Contributor: Jared Scott, MD Educational Pearls: About ½ of the patients in the ED present with some form of pain One study looked at patients presenting in pain and followed up two days after disch...

3 Mai 20215min

Podcast 665: Allergic Reactions after COVID Vaccinations

Podcast 665: Allergic Reactions after COVID Vaccinations

Contributor: Peter Bakes, MD Educational Pearls: Incidence 2.5-10 per million people occurring primarily in those with environmental allergens Typically occurs with mRNA vaccines in lipid nanopartic...

28 Apr 20214min

Populært innen Vitenskap

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