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(1147)

Podcast # 458: A Tylenol a Day Keeps the Delirium Away?

Podcast # 458: A Tylenol a Day Keeps the Delirium Away?

Author: Nick Hatch, MD Educational Pearls: A recent study investigated the effect of scheduled IV acetaminophen on the incidence of delirium in post-CABG patients in the ICU The use of scheduled IV...

17 Apr 20193min

Podcast # 457: Stroke Scores

Podcast # 457: Stroke Scores

Author: Jared Scott, MD Educational Pearls: Modified Rankin Score: measure of disability often used to qualify outcomes following stroke = no disability, 6=dead, 0-1 indicate good outcome) 0-6 S...

15 Apr 20194min

Podcast # 456 Hypoglycemia: Not feeling so sweet

Podcast # 456 Hypoglycemia: Not feeling so sweet

Author: Jared Scott, MD Educational Pearls: Beta-blockers can mask the effects of hypoglycemia Prolonged/refractory hypoglycemia should raise a suspicion for sulfonylurea (or other oral hypoglycemi...

12 Apr 20194min

Podcast # 455: Hunting for PeeCP

Podcast # 455: Hunting for PeeCP

Author: Michael Hunt, MD Educational Pearls: Like all tests, urine toxicology (utox) screens can have false positives Prescription medications such as demerol, antipsychotics, ketamine, and tramado...

11 Apr 20193min

Podcast # 454: Tylenol Overdose

Podcast # 454: Tylenol Overdose

Educational Pearls: Acetaminophen overdose can also present in patients taking too much over the course of days to weeks - not just intentional ingestions If acute overdose is suspected, refer to t...

9 Apr 20194min

Podcast # 453:  Headache Triggers

Podcast # 453: Headache Triggers

Author: Sam Killian, MD Educational Pearls:   Headache is a common complaint in the ED. It's plausible that headaches could be correlated with environmental factors A 2015 study ED visits for headach...

4 Apr 20192min

Podcast # 452: CADASIL

Podcast # 452: CADASIL

Author: Sam Killian, MD Educational Pearls: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) occurs in 1:100000 individuals The disease is caused b...

1 Apr 20193min

Podcast # 451: NSAIDs

Podcast # 451: NSAIDs

Author: Don Stader, MD Educational Pearls: Non-steroidal anti-inflammatory drugs (NSAIDs) are effective pain relievers but come with important side effects NSAIDs inhibit COX-1 and/or COX-2, which de...

29 Mar 20193min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
rss-paradigmepodden
sinnsyn
forskningno
villmarksliv
pod-britannia
fjellsportpodden
dekodet-2
rss-lundqvist-podden
rss-nysgjerrige-norge
hva-er-greia-med
tidlose-historier
rss-overskuddsliv
diagnose
tomprat-med-gunnar-tjomlid