• Cleve Clin J Med · May 2022

    Review

    Psychogenic nonepileptic seizure: An empathetic, practical approach.

    • Becky Bikat S Tilahun and Jocelyn F Bautista.
    • Department of Psychiatry and Psychology, Cleveland Clinic; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH.
    • Cleve Clin J Med. 2022 May 2; 89 (5): 252-259.

    AbstractPsychogenic nonepileptic seizure (PNES) is often misdiagnosed as epilepsy, leading to unnecessary treatments and procedures, as well as failure to engage patients in needed mental health care. To establish an accurate diagnosis, video electroencephalography (EEG) in the context of and simultaneous with a comprehensive neurologic and psychosocial evaluation is recommended for any patient with seizures that are not responding to treatment. Delivering the diagnosis with empathy and respect is a crucial component of care that helps patients establish trust with caregivers and follow treatment recommendations. Effective treatment is available, highlighting the importance of early diagnosis to avoid unnecessary and potentially harmful treatment. But there are many barriers to care, including provider misperceptions, lack of acceptance of the diagnosis, poor patient engagement with treatment, and lack of access to care.Copyright © 2022 The Cleveland Clinic Foundation. All Rights Reserved.

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