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.


Avsnitt(1146)

Podcast 827: Allergies in Peds

Podcast 827: Allergies in Peds

Contributor: Aaron Lessen, MD Educational Pearls: Recent study evaluated if early exposure to an allergen impacted the rate of allergy development later in childhood Children were exposed to peanut, ...

7 Nov 20222min

Podcast 826: STEMI Equivalents

Podcast 826: STEMI Equivalents

Contributor: Travis Barlock, MD Educational Pearls: The presence of a STEMI has traditionally been used to determine if a patient with acute chest pain requires urgent cath lab management STEMI indi...

1 Nov 20224min

Podcast 825: ALS vs PD Transport

Podcast 825: ALS vs PD Transport

Contributor: Aaron Lessen, MD Educational Pearls: In urban settings, it is becoming more common for police to transport critical patients from scene to hospital A 2022 multicenter observational study...

31 Okt 20222min

Podcast 824: Catheter-Related Blood Infections

Podcast 824: Catheter-Related Blood Infections

Contributor: Travis Barlock, MD Educational Pearls: Catheter related blood infections were thought to be caused by skin flora seeding the catheter. Thus, significant effort is applied to sterility an...

25 Okt 20223min

Podcast 823: Immediate Resuscitative Thoracotomy

Podcast 823: Immediate Resuscitative Thoracotomy

Contributor: Jared Scott, MD Educational Pearls: Immediate resuscitative thoracotomy can be performed in the ED to gain rapid access to the thoracic cavity in cases of traumatic cardiac arrest Wester...

24 Okt 20227min

Podcast 822: Meralgia Paresthetica

Podcast 822: Meralgia Paresthetica

Contributor: Aaron Lessen, MD Educational Pearls: Lateral Cutaneous Femoral Nerve Entrapment Syndrome, also known as Meralgia Paresthetica, results from entrapment of the lateral cutaneous femoral ne...

18 Okt 20223min

Podcast 821: EKGs in Syncope

Podcast 821: EKGs in Syncope

Contributor: Travis Barlock, MD Educational Pearls: An EKG should be obtained quickly after a syncopal event to identify possible life-threatening causes such as ischemia and arrhythmia WOBBLER is a...

17 Okt 20224min

Podcast 820: Who Qualifies for Take-Home Naloxone

Podcast 820: Who Qualifies for Take-Home Naloxone

Contributor: Don Stader, MD Educational Pearls: Home naloxone is traditionally given to those at high risk for opioid overdose such as those in the ED due to an opioid overdose, opioid intoxication, ...

11 Okt 20224min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
rss-ufo-bortom-rimligt-tvivel
sexet
rss-vetenskapsradion
pojkmottagningen
rss-vetenskapsradion-2
dumforklarat
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
halsorevolutionen
rss-spraket
bildningspodden
hacka-livet
rss-experimentet
medicinvetarna
rss-lara-fran-larda-en-fackbok-och-en-forfattare