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Journal of Pediatric Epilepsy 2017; 06(01): 075-080
DOI: 10.1055/s-0036-1585067
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Toward Evidenced-Based Assessment and Treatment of Pediatric Psychogenic Nonepileptic Seizures

Alexandra M. Psihogios
1   Department of Psychology, Loyola University Chicago, Chicago, Illinois, United States
2   Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
,
Tina Drossos
3   Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, United States
,
Khalid I. Afzal
3   Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, United States
› Author Affiliations
Further Information

Publication History

20 March 2015

21 March 2016

Publication Date:
11 July 2016 (online)

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Abstract

Objective Psychogenic nonepileptic seizures are common among children and adolescents, but evidenced-based assessment and treatment guidelines are lacking. This review aimed to evaluate the current status of the pediatric literature on psychogenic nonepileptic seizures (PNES).

Method A review of the relevant pediatric literature was performed. A case example was constructed to further elucidate assessment and treatment of pediatric PNES in a clinical context.

Results The most common manifestation of PNES in children and adolescents is motionless unresponsiveness. Youth typically experience psychological dysfunction, including somatization, history of trauma, depression, anxiety, and school problems. Simultaneous video and 24-hour electroencephalogram recordings are gold standards of PNES assessment, but neuropsychological evaluation offers an additional tool for diagnosing PNES. Rigorous research on the effectiveness of psychotherapy for pediatric PNES patients is lacking.

Conclusion In addition to electrophysiological characteristics, there are several core clinical features that distinguish epileptic from nonepileptic events, including higher rates of somatization among youth with PNES. Psychoeducation combined with cognitive behavioral therapy and the use of selective serotonin reuptake inhibitors may be beneficial for reducing symptom burden.

Keywords

psychogenic - nonepileptic - seizures - pediatric - pseudoseizures
 

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