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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Main Authors: Jung Sook Yeom, Heather Bernard, Sookyong Koh
Format: Article
Language:English
Published: The Korean Pediatric Society 2021-06-01
Series:Clinical and Experimental Pediatrics
Subjects:
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.
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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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