Psychogenic Nonepileptic Seizures

Psychogenic nonepileptic seizures (PNES) are attacks that mimic epileptic seizures, but are not caused by abnormal electrical discharges in the brain. Instead, PNES are typically considered involuntary expressions of distress, making diagnosis and treatment a challenge. Historically, patients are referred to neurologists who, after completing a diagnostic work up, refer patients to mental health professionals, including psychiatrists, for treatment. For a number of reasons, this transition of care between specialists is often not successful, and this impacts patient treatment and outcomes. Psychogenic Nonepileptic Seizures: Toward the Integration of Care offers new insights into the practical diagnostic and treatment challenges faced by clinicians who manage this condition. This book covers the different stages of care, from the initial evaluation to long-term outcomes, and highlights the need to work collaboratively to provide patients with comprehensive care and improved outcomes. It provides up-to-date evidence and shares clinical expertise for the management of this challenging diagnosis that requires the expertise of a multi-disciplinary team. The authors provide a new framework on how to conceptualize and manage this disorder to more effectively address the needs of patients.

Dr. Dworetzky is the Chief of Epilepsy at the Brigham and Women's Hospital and Associate Professor at Harvard Medical School. She leads the large multidisciplinary Bromfield Epilepsy Program and directs the EEG laboratory and the clinical training fellowships in her field. Dr. Dworetzky is the Chair of the Clinical Council of Activities for the American Epilepsy Society and is a leading expert in psychogenic nonepileptic seizures. Together with Dr. Baslet, she sees patients in a shared clinical setting to enhance patient engagement in treatment.
Dr. Gaston Baslet is an Associate Psychiatrist at Brigham and Women's Hospital and Assistant Professor at Harvard Medical School. He specializes in the neuropsychiatric aspects of epilepsy and functional neurological symptom disorder, including psychogenic non-epileptic seizures. His particular focus is in the development of therapeutic strategies for short-term and long-term management of PNES.

- Table of Contents
- Preface
- Contributors List
- Section I: Clinical Setting
- Chapter 1: Ambulatory Presentations in Adults and Children
- Mary Angela O'Neal, MD and Rochelle Caplan, MD
- Chapter 2: Emergency Department and Urgent Care Presentations
- Daniel Weisholtz, MD and Barbara A. Dworetzky, MD
- Section II: Etiologic Factors
- Chapter 3: Psychiatric Factors
- Kim Bullock, MD and John Barry, MD
- Chapter 4: Neurologic and Medical Factors
- Victoria S. S. Wong, MD and Martin Salinsky, MD
- Chapter 5: Mechanisms of Possible Neurocognitive Dysfunction
- Daniel L. Drane, PhD and Dona E. C. Locke, PhD
- Chapter 6: The Neurobiology of PNES and Other Functional Neurological Symptoms
- David L. Perez, MD and Valerie Voon MD, PhD
- Section III: Diagnostic Procedures
- Chapter 7: Diagnostic Challenges for the Neurologist
- Jigar Rathod, MD and Selim R. Benbadis, MD
- Chapter 8: Diagnostic Challenges for the Mental Health Team and Psychiatrist
- Lorna Myers, PhD and John Barry, MD
- Chapter 9: Practical and Diagnostic Challenges for the Neuropsychologist
- Kim Willment, PhD and David Loring, PhD
- Section IV: Principles of Treatment
- Chapter 10: Communicating the Diagnosis
- Markus Reuber, MD, PhD
- Chapter 11: Clinicians' Response to the Diagnosis
- Sigita Pliopys, MD, Shan Abbas, MD, and Brien Smith, MD
- Chapter 12: Models of Care
- Tyson Sawchuk MSc, RPsych, Joan K Austin, PhD, RN, FAAN, and Debbie Terry, MS, CNP
- Chapter 13: Readiness to Start Treatment and Obstacles to Adherence
- Benjamin Tolchin, MD and Gaston Baslet, MD
- Section V: Treatment Interventions
- Chapter 14: Evidence-Based Treatments
- W. Curt LaFrance Jr., MD, MPH and Laura H. Goldstein, PhD, MPhil
- Chapter 15: The Role of the Neurologist after Diagnosis
- Adriana Bermeo-Ovalle, MD and Andres M. Kanner, MD, FANA
- Chapter 16: The Roles of the Patient and Family
- Julia L. Doss, PsyD, LP and Jeffrey Mark Robbins, MSW
- Section VI: Long-Term Outcomes and Prognosis
- Chapter 17: Long-Term Outcomes
- Roderick Duncan, MD, PhD
- Chapter 18: An Integrated Approach to other Functional Neurological Symptoms and Related Disorders
- Jon Stone, MB, ChB, FRCP, PhD and Alan Carson, MD
- Chapter 19: Towards the Integration of Care
- Gaston Baslet, MD and Barbara A. Dworetzky, MD