Evidence-Based Practice for the Clinical Assessment of Psychogenic Nonepileptic Seizures: A Report From the American Neuropsychiatric Association Committee on Research.

Baslet, Gaston; Bajestan, Sepideh N; Aybek, Selma; Modirrousta, Mandana; D Clin Psy, Jason Price; Cavanna, Andrea; Perez, David L; Lazarow, Shelby Scott; Raynor, Geoffrey; Voon, Valerie; Ducharme, Simon; LaFrance, W Curt (2021). Evidence-Based Practice for the Clinical Assessment of Psychogenic Nonepileptic Seizures: A Report From the American Neuropsychiatric Association Committee on Research. The journal of neuropsychiatry and clinical neurosciences, 33(1), pp. 27-42. American Psychiatric Association 10.1176/appi.neuropsych.19120354

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The American Neuropsychiatric Association's Committee on Research assigned the task of defining the most helpful clinical factors and tests in establishing the diagnosis of psychogenic nonepileptic seizures (PNES) during a neuropsychiatric assessment. A systematic review of the literature was conducted using three search engines and specified search terms for PNES and the predetermined clinical factors and diagnostic tests, followed by a selection process with specific criteria. Data extraction results from selected articles are presented for clinical factors (semiology, psychiatric comorbidities, medical comorbidities, psychological traits) and diagnostic tests (EEG, psychometric and neuropsychological measures, prolactin level, clinical neuroimaging, autonomic testing). Semiology with video EEG (vEEG) remains the most valuable tool to determine the diagnosis of PNES. With the exception of semiology, very few studies revealed the predictive value of a clinical factor for PNES, and such findings were isolated and not replicated in most cases. Induction techniques, especially when coupled with vEEG, can lead to a captured event, which then confirms the diagnosis. In the absence of a captured event, postevent prolactin level and personality assessment can support the diagnosis but need to be carefully contextualized with other clinical factors. A comprehensive clinical assessment in patients with suspected PNES can identify several clinical factors and may include a number of tests that can support the diagnosis of PNES. This is especially relevant when the gold standard of a captured event with typical semiology on vEEG cannot be obtained.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Aybek, Selma

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1545-7222

Publisher:

American Psychiatric Association

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

12 Nov 2020 17:20

Last Modified:

23 Jan 2021 01:32

Publisher DOI:

10.1176/appi.neuropsych.19120354

PubMed ID:

32778006

Uncontrolled Keywords:

Conversion Disorder Functional Neurological Disorder Psychogenic Nonepileptic Seizures Seizures Somatoform Disorders

BORIS DOI:

10.7892/boris.147392

URI:

https://boris.unibe.ch/id/eprint/147392

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