Myths and truths about pediatric psychogenic nonepileptic seizures
Psychogenic nonepileptic seizures (PNES) is a neuropsychiatric condition that causes a transient alteration of consciousness and loss of self-control. PNES, which occur in vulnerable individuals who often have experienced trauma and are precipitated by overwhelming circumstances, are a body’s expres...
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Format: | Article |
Language: | English |
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The Korean Pediatric Society
2021-06-01
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Series: | Clinical and Experimental Pediatrics |
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Online Access: | http://www.e-cep.org/upload/pdf/cep-2020-00892.pdf |
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author | Jung Sook Yeom Heather Bernard Sookyong Koh |
author_facet | Jung Sook Yeom Heather Bernard Sookyong Koh |
author_sort | Jung Sook Yeom |
collection | DOAJ |
description | Psychogenic nonepileptic seizures (PNES) is a neuropsychiatric condition that causes a transient alteration of consciousness and loss of self-control. PNES, which occur in vulnerable individuals who often have experienced trauma and are precipitated by overwhelming circumstances, are a body’s expression of a distressed mind, a cry for help. PNES are misunderstood, mistreated, under-recognized, and underdiagnosed. The mindbody dichotomy, an artificial divide between physical and mental health and brain disorders into neurology and psychiatry, contributes to undue delays in the diagnosis and treatment of PNES. One of the major barriers in the effective diagnosis and treatment of PNES is the dissonance caused by different illness perceptions between patients and providers. While patients are bewildered by their experiences of disabling attacks beyond their control or comprehension, providers consider PNES trivial because they are not epileptic seizures and are caused by psychological stress. The belief that patients with PNES are feigning or controlling their symptoms leads to negative attitudes of healthcare providers, which in turn lead to a failure to provide the support and respect that patients with PNES so desperately need and deserve. A biopsychosocial perspective and better understanding of the neurobiology of PNES may help bridge this great divide between brain and behavior and improve our interaction with patients, thereby improving prognosis. Knowledge of dysregulated stress hormones, autonomic nervous system dysfunction, and altered brain connectivity in PNES will better prepare providers to communicate with patients how intangible emotional stressors could cause tangible involuntary movements and altered awareness. |
first_indexed | 2024-12-22T02:08:02Z |
format | Article |
id | doaj.art-9ec0a94b56264483aaf22c320aa610ea |
institution | Directory Open Access Journal |
issn | 2713-4148 |
language | English |
last_indexed | 2024-12-22T02:08:02Z |
publishDate | 2021-06-01 |
publisher | The Korean Pediatric Society |
record_format | Article |
series | Clinical and Experimental Pediatrics |
spelling | doaj.art-9ec0a94b56264483aaf22c320aa610ea2022-12-21T18:42:28ZengThe Korean Pediatric SocietyClinical and Experimental Pediatrics2713-41482021-06-0164625125910.3345/cep.2020.0089220125555371Myths and truths about pediatric psychogenic nonepileptic seizuresJung Sook Yeom0Heather Bernard1Sookyong Koh2 Department of Pediatrics, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA, USA Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USAPsychogenic nonepileptic seizures (PNES) is a neuropsychiatric condition that causes a transient alteration of consciousness and loss of self-control. PNES, which occur in vulnerable individuals who often have experienced trauma and are precipitated by overwhelming circumstances, are a body’s expression of a distressed mind, a cry for help. PNES are misunderstood, mistreated, under-recognized, and underdiagnosed. The mindbody dichotomy, an artificial divide between physical and mental health and brain disorders into neurology and psychiatry, contributes to undue delays in the diagnosis and treatment of PNES. One of the major barriers in the effective diagnosis and treatment of PNES is the dissonance caused by different illness perceptions between patients and providers. While patients are bewildered by their experiences of disabling attacks beyond their control or comprehension, providers consider PNES trivial because they are not epileptic seizures and are caused by psychological stress. The belief that patients with PNES are feigning or controlling their symptoms leads to negative attitudes of healthcare providers, which in turn lead to a failure to provide the support and respect that patients with PNES so desperately need and deserve. A biopsychosocial perspective and better understanding of the neurobiology of PNES may help bridge this great divide between brain and behavior and improve our interaction with patients, thereby improving prognosis. Knowledge of dysregulated stress hormones, autonomic nervous system dysfunction, and altered brain connectivity in PNES will better prepare providers to communicate with patients how intangible emotional stressors could cause tangible involuntary movements and altered awareness.http://www.e-cep.org/upload/pdf/cep-2020-00892.pdfneurobiologydissociative reactionemotional stressnonepileptic seizuresomatic symptoms |
spellingShingle | Jung Sook Yeom Heather Bernard Sookyong Koh Myths and truths about pediatric psychogenic nonepileptic seizures Clinical and Experimental Pediatrics neurobiology dissociative reaction emotional stress nonepileptic seizure somatic symptoms |
title | Myths and truths about pediatric psychogenic nonepileptic seizures |
title_full | Myths and truths about pediatric psychogenic nonepileptic seizures |
title_fullStr | Myths and truths about pediatric psychogenic nonepileptic seizures |
title_full_unstemmed | Myths and truths about pediatric psychogenic nonepileptic seizures |
title_short | Myths and truths about pediatric psychogenic nonepileptic seizures |
title_sort | myths and truths about pediatric psychogenic nonepileptic seizures |
topic | neurobiology dissociative reaction emotional stress nonepileptic seizure somatic symptoms |
url | http://www.e-cep.org/upload/pdf/cep-2020-00892.pdf |
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