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Psychogenic nonepileptic seizures: to the issue of diagnosis and patient management (with a case report)

https://doi.org/10.17749/2077-8333/epi.par.con.2021.056

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Abstract

Establishing misdiagnosis “epilepsy” is a common event comprising 25% total cases of “pharmacoresistant” forms. Eventually, the majority of cases resulted in diagnosing psychogenic nonepileptic seizures, or functional seizures, conversion seizures, and dissociative seizures. Here we review publications assessing psychogenic non-epileptic seizures. The scientific resources for analysis were selected in Russian (eLibrary) and international (Pubmed/MEDLINE, Google Scholar) databases, as well as in open access resources. We also present a clinical case of a patient diagnosed with epilepsy. In particular, the patient was admitted to the hospital with complains of paroxysmal conditions starting as headache, nausea proceeding with speech arrest and decreased mindfulness of what happens in personal life. He also informed about at least two episodes of disorientation described as “missed public transport stop” and “finding himself in unfamiliar place”. The patient underwent examination (electroencephalography, brain magnetic resonance imaging) and dynamic follow-up to verify origin of such conditions. As a result, he was diagnosed with psychogenic non-epileptic seizures. Administering proper therapy allowed to achieve stabilized condition and arrest seizures. The criteria provided in the review as well as clinical case report may help clinical practitioners to timely conduct differential diagnostics and deliver specialized medical aid.

About the Authors

N. I. Shova
Bekhterev National Medical Research Centre for Psychiatry and Neurology
Russian Federation

Natalia I. Shova – Postgraduate Student

Scopus Author ID: 57215893698; RSCI SPIN-code: 1952-3043

3 Bekhtereva Str., Saint Petersburg 192019



D. V. Alekseeva
Bekhterev National Medical Research Centre for Psychiatry and Neurology
Russian Federation

Diana V. Alekseeva – Junior Researcher, Department for the Treatment of Patients with Exogenous Organic Disorders and Epilepsy

Scopus Author ID: 57216917954; RSCI SPIN-code: 2331-8682

3 Bekhtereva Str., Saint Petersburg 192019



V. A. Mikhailov
Bekhterev National Medical Research Centre for Psychiatry and Neurology
Russian Federation

Vladimir A. Mikhailov – Dr. Med. Sc., Deputy Director for Innovative Scientific Development, Head of the International Department, Chief Researcher and Scientific Director of the Department of Treatment of Organic Mental Disorders and Epilepsy and Rehabilitation of Patients with Psychosomatic Disorders

WoS ResearcherID: B-3272-2017; RSCI SPIN-code: 5563-1009

3 Bekhtereva Str., Saint Petersburg 192019



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For citation:


Shova N.I., Alekseeva D.V., Mikhailov V.A. Psychogenic nonepileptic seizures: to the issue of diagnosis and patient management (with a case report). Epilepsy and paroxysmal conditions. 2021;13(2):147-156. (In Russ.) https://doi.org/10.17749/2077-8333/epi.par.con.2021.056

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ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)