Psychogenic Nonepileptic Seizures: Toward the Integration of Care

ISBN : 9780190265045

Barbara A. Dworetzky; Gaston Baslet
320 ページ
156 x 235 mm

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.


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


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.