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 687: STI Complications

Podcast 687: STI Complications

Contributor: Jared Scott, MD Educational Pearls: PID (pelvic inflammatory disease) occurs when the infection ascends into the uterus Tubo-ovarian abscess occurs when the infection ascends to the fall...

30 Juni 20214min

Podcast 686: Vaginal Self Swabs

Podcast 686: Vaginal Self Swabs

Contributor: Jared Scott, MD Educational Pearls: Recent study evaluated vaginal self swab testing for STIs to determine if they are equally sensitive to provider-obtained swab 515 patients consented ...

29 Juni 20213min

Podcast 685: Cultural Sensitivity with LGBTIQ+ Patients

Podcast 685: Cultural Sensitivity with LGBTIQ+ Patients

Contributor: Dr. Nick Gorton, MD Educational Pearls: Use transgender people's correct names and pronouns, the Russell study found a 56% reduction in suicide behavior with chosen name usage ⅕ to ½ of ...

28 Juni 202110min

Podcast 684: Acidosis

Podcast 684: Acidosis

Contributor:  Nick Tsipis, MD Educational Pearls: pH 7.45=alkalemia If pH low and pCO2 high, indicates a respiratory acidosis If pH low and pCO2 low, indicates metabolic acidosis After determining ty...

23 Juni 20216min

Podcast 683: Zofran vs. Haldol for Cannabinoid Hyperemesis Syndrome

Podcast 683: Zofran vs. Haldol for Cannabinoid Hyperemesis Syndrome

Contributor: Jared Scott, MD Educational Pearls: Around 30 patients with cannabinoid hyperemesis syndrome (CHS) randomized treatment in three arms with 8mg Zofran, Haldol 0.05 mg/kg, and Haldol 0.1 ...

22 Juni 20215min

Podcast 682: Snake Bites

Podcast 682: Snake Bites

Contributor: Gretchen Hinson, MD Educational Pearls: Pit vipers include cottonmouths, rattlesnakes, and copperheads All have folding long fangs, triangular face, and elliptical pupils About 5,00...

21 Juni 20216min

Podcast 681: Internal Hernias

Podcast 681: Internal Hernias

Contributor: Adam Barkin, MD Educational Pearls: Internal hernias, when bowel herniates through iatrogenic or congenital defect in mesentery, represent 1-6% of all small bowel obstructions Mortality...

16 Juni 20215min

Podcast 680: Coronary Artery Dissection

Podcast 680: Coronary Artery Dissection

Contributor: Adam Barkin, MD Educational Pearls: Spontaneous coronary artery dissection (SCAD) is the most common cause of acute MI in women under 50 years old Risk factors include fibromuscular dys...

15 Juni 20214min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
rss-vetenskapsradion
rss-ufo-bortom-rimligt-tvivel
medicinvetarna
rss-vetenskapsradion-2
rss-experimentet
det-morka-psyket
sexet
rss-spraket
hacka-livet
dumforklarat
pojkmottagningen
rss-personlighetspodden
rss-arkeologi-historia-podden-som-graver-i-vart-kulturlandskap
paranormalt-med-caroline-giertz
halsorevolutionen