Dissoci ative Seizures


Authors: J. Praško  1 3;  P. Pastucha 1;  M. Raszka 2,3;  K. Látalová 1;  E. Herman  4 6;  J. Hovorka 6,7;  P. Do ubek 5
Authors‘ workplace: Klinika psychi atrie LF UP a FN Olomouc, 2Centrum neuropsychi atrických studií, Praha, 3Psychiatrické centrum Praha, 4Psychiatrická ambulance Praha, 5Psychiatrická klinika 1. LF UK a VFN v Praze, 6Neurologické oddělení, epileptologické a neuropsychiatrick 1
Published in: Cesk Slov Neurol N 2009; 72/105(5): 429-436
Category: Review Article

Overview

Dissoci ative seizures are paroxysmal episodes of disturbed behavi or that be ar some resemblance to epileptic seizures but are not attributable to any organic disturbance, including epilepsy. Dissoci ative seizures are common, acco unting for up to 20% of pati ents tho ught to have medically intractable epilepsy. In many cases, the correct di agnosis is missed for several ye ars, during which time pati ents are tre ated with anti epileptic drugs witho ut any therape utic effects. Polypharmacy is common, and the disorder is often suspected only after successive tri als of anti epileptic medicati on prove ineffective. The disorder carri es a po or prognosis: the majority of pati ents remains o ut of employment and have a po or soci al o utcome even if seizures become less frequent or resolve. There have been several retrospective case seri es and a number of a uthors have o utlined general principles of management. There was published an open, prospective successful tri al of cognitive behavior therapy in pati ents with dissoci ative seizures attending a speci alist ne uropsychi atry service.

Key words:
dissoci ative seizures –  di agnosis –  differenti al di agnosis –  case management –  cognitive behavi or therapy


Sources

1. Scull DA. Pse udoseizures or non‑epileptic seizures (NES); 15 synonyms. J Ne urol Ne urosurg Psychi atry 1997; 62(2): 200.

2. Vojtěch Z. Pse udozáchvaty (neepileptické psychogenní záchvaty) –  so učasný pohled a di agnostické možnosti. Cesk Slov Ne urol N 2000; 63(2): 69– 76.

3. Herman E, Hovorka J, Praško J. Disoci ativní poruchy. In: Herman E, Praško J, Seifertová D (eds). Konsili ární psychi atri e. Praha: Medical Tribune 2007: 293– 304.

4. World He alth Organizati on. The ICD- 10 Classificati on of Mental and Behavi o ural Disorders. Clinical Descripti on and Di agnostic Guidelines. Geneva, Switzerland: World He alth Organizati on 1992: 151– 161.

5. Benbadis SR, Allen Ha user WA. An estimate of the prevalence of psychogenic non‑epileptic seizures. Seizure 2000; 9(4): 280– 281.

6. Hovorka J, Nežádal T, Herman E. Epileptické a neepileptické psychogenní záchvaty v ne uropsychi atrickém centru, Nemocnice Na Františku: di agnostické zkušenosti. Psychi atri e 2003; 7 (Suppl 2): 37– 38.

7. Ettinger AB, Dho on A, Weisbrot DM, Devinsky O. Predictive factors for o utcome of nonepileptic seizures after di agnosis. J Ne uropsychi atry Clin Ne urosci 1999; 11(4): 458– 463.

8. Kristensen O, Alving J. Pse udoseizures –  risk factors and prognosis. A case- control study. Acta Ne urol Scand 1992; 85(3): 177– 180.

9. Stu art S, Noyes R jr. Attachment and interpersonal communicati on in somatizati on. Psychosomatics 1999; 40(1): 34– 43.

10. Brown RJ, Trimble MR. Dissoci ative psychopathology, non‑epileptic seizures, and ne urology. J Ne urol Ne urosurg Psychi atry 2000; 69(3): 285– 289.

11. Betts T. Pse udoseizures: seizures that are not epilepsy. Lancet 1990; 336: 163– 164.

12. Putnam FW. Dissoci ative phenomena. In: Tasman A,Goldfinger SM (eds). American Psychi atric Press Annu al Revi ew of Psychi atry. 10th ed. Washington DC: American Psychi atric Associ ati on 1991: 145– 160.

13. Vein AM, Djukova GM, Vorobi eva OV. Is panic attack a mask of psychogenic seizures? A comparative analysis of phenomenology of psychogenic seizures and panic attacks. Funct Ne urol 1994; 9(3):153– 159.

14. Lempert T, Schmidt D. Natural history and o utcome of psychogenic seizures: a clinical study in 50 pati ents. J Ne urol 1990; 237(1): 35– 38.

15. Bowman ES, Markand ON. Psychodynamics and psychi atric di agnoses of pse udoseizures subjects. Am J Psychi atry 1996; 153(1): 57– 63.

16. Mo ore PM, Baker GA, McDade G, Chadwick D, Brown S. Epilepsy, pse udoseizures and perceived family characteristics: a controlled study. Epilepsy Res 1994; 18(1): 75– 83.

17. Krawetz P, Fleisher W, Pillay N, Staley D, Arnett J, Maher J. Family functi oning in subjects with pse udoseizures and epilepsy. J Nerv Ment Dis 2001; 189(1): 38– 43.

18. Wo od BL, McDani el S, Burchfi eld K, Erba G. Factors distinguishing famili es of pati ents with psychogenic seizures from famili es of pati ents with epilepsy. Epilepsi a 1998; 39(4): 432– 437.

19. Alper K, Devinsky O, Perrine K, Vazquez B, Luci ano D.Nonepileptic seizures and childho od sexu al and physical abuse. Ne urology 1993; 43(10): 1950– 1953.

20. Kuyk J, Van Dyck R, Spinhoven P. The case for a dissoci ative interpretati on of pse udoepileptic seizures. J Nerv Ment Dis 1996; 184(8): 468– 474.

21. Goldstein LH, Drew C, Mellers J, Mitchell- O’Malley S, Oakley DA. Dissoci ati on, hypnotizability, coping styles and he alth locus of control: characteristics of pse udoseizure pati ents. Seizure 2000; 9(5): 314– 322.

22. Prueter C, Schultz- Venrath U, Rimpa u W. Dissoci ative and associ ative psychopathological symptoms in pati ents with epilepsy, pse udoseizures and both seizure forms. Epilepsi a 2002; 43(2): 188– 192.

23. Slavney PR. Pse udoseizures, sexu al abuse, and hermene utic re asoning. Compr Psychi atry 1994; 35(6): 471– 477.

24. Chalder T. Non- epileptic attacks; a cognitive behavi oral appro ach in a single case with a fo ur ye ar follow‑up. Clin Psychol Psychother 1996; 3: 291– 297.

25. Goldstein LH, De ale AC, Mitchell- O’Malley SJ, To one BK, Mellers JD. An Evalu ati on of Cognitive Behavi oral Therapy as a Tre atment for Dissoci ative Seizures: a Pilot Study. Cogn Behav Ne urol 2004; 17(1): 41– 49.

26. Herman E, Hovorka J, Nežádal T, Praško J. Disoci ativní poruchy. In: Seifertová D, Praško J, Höschl C (eds). Postupy v léčbě psychických poruch. Praha: Amepra 2004.

27. Devinsky O, Kelley K, Porter RJ, The odore WH. Clinical and electroencephalographic fe atures of simple parti al seizures. Ne urology 1988; 38(9): 1347– 1352.

28. Lachenmeyer JR, Olsen ME. Behavi o ur modificati on in the tre atment of pse udoseizures: a case report. Behav Psychother 1990; 18: 73– 78.

29. Savard G, Andermann F. Convulsive pse udoseizures: a revi ew of current concepts. Behav Ne urol 1990; 3: 133– 141.

30. Bowman ES. Eti ology and clinical co urse of pse udoseizures. Relati onship to tra uma, depressi on, and dissoci ati on. Psychosomatics 1993; 34(4): 33– 342.

31. Betts T, Boden S. Di agnosis, management and prognosis of a gro up of 128 pati ents with non‑epileptic attack disorder. Part 1. Seizure 1992; 1(1): 19– 26.

32. McDade G, Brown SW. Non- epileptic seizures: management and predictive factors of o utcome. Seizure 1992; 1(1): 7– 10.

33. Abo ukasm A, Mahr G, Rader Gahry B, Thomas A,Barkley GL. Retrospective analysis of the effects of psychotherape utic interventi ons on o utcomes of psychogenic nonepileptic seizures. Epilepsi a 1998; 39(5): 470– 473.

34. LaFrance WC jr, Alper K, Babcock D, Barry JJ, Benbadis S, Caplan R et al. Nonepileptic seizures tre atment workshop summary. Epilepsy Behav 2006; 8(3): 451– 461.

35. Oto M, Espi e C, Pelosi A, Selkirk M, Duncan R. The safety of anti epileptic drug withdrawal in pati ents with non‑epileptic seizures. J Ne urol Ne urosurg Psychi atry 2005; 76(12): 1682– 1685.

36. Slavney PR. In defense of pse udoseizures. Gen Hosp Psychi atry 1994; 16(4): 243– 245.

37. Ettinger AB, Devinsky O, Weisbrot DM, Ramakrishna RK, Goyal A. A comprehensive profile of clinical, psychi atric and psychosoci al characteristics of pati ents with psychogenic nonepileptic seizures. Epilepsi a 1999; 40(9): 1292– 1298.

38. Kanner AM, Parra J, Frey M, Stebbins G, Pi erre‑Lo uis S, Iri arte J. Psychi atric and ne urologic predictors of psychogenic pse udoseizure o utcome. Ne urology 1999; 53(5): 933– 938.

39. Walczak TS, Papacostas S, Willi ams DT, Sche uer ML, Lebowitz N, Notarfrancesco A. Outcome after di agnosis of psychogenic nonepileptic seizures. Epilepsi a 1995; 36(11): 1131– 1137.

40. Griffith JL, Polles A, Griffith ME. Pse udoseizures famili es and unspe akable dilemmas. Psychosomatics 1998; 39(2): 144– 153.

41. Buchanan N, Snars J. Pse udoseizures (non epileptic attack disorder) –  clinical management and o utcome in 50 pati ents. Seizure 1993; 2(2): 141– 146.

42. Cohen S, Willi amson GM. Perceived stress in a probability sample of the United States. In: Spacapan A, Oscamp S (eds). The Soci al Psychology of He alth. Californi a: Sage 1988: 30– 48.

43. Salkovskis PM. Somatic problems. In: Hawton K, Salkovskis PM, Kirk J et al (eds). Cognitive Behavi o ur Therapy for Psychi atric Problems. Oxford: Oxford University Press 1989: 235– 276.

44. Kennerley H. Cognitive therapy of dissoci ative symptoms associ ated with tra uma. Br J Clin Psychol 1996; 35(3): 325– 340.

45. Speckens AE, van Hemert AM, Spinhoven P, Hawton KE, Bolk JH, Ro o ijmans HG. Cognitive behavi oral therapy for medically unexplained physical symptoms: a randomised controlled tri al. BMJ 1995; 311(7016): 1328– 1332.

46. Herman E, Hovorka J, Praško J, Nežádal T, Bajaček M,Doubek P. Disociativní poruchy v praxi. Psychiat pro Praxi 2008, 9(6): 277-282.

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Paediatric neurology Neurosurgery Neurology
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