4.5 Review

Treatment of Psychogenic Nonepileptic Seizures

Journal

CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS
Volume 22, Issue 8, Pages 467-474

Publisher

SPRINGER
DOI: 10.1007/s11910-022-01209-3

Keywords

Treatment; Psychogenic nonepileptic seizures; Dissociative seizures; Cognitive behavioral therapy; Functional seizures

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This review summarizes the recent advances in the diagnosis and treatment of psychogenic nonepileptic seizures (PNES). It emphasizes the effectiveness of psychotherapeutic modalities in empowering patients and reducing seizures, and highlights the importance of a multidisciplinary and holistic approach. The review also suggests the need for additional treatment modalities and further research for patients who are refractory to current treatment.
Purpose of Review Psychogenic nonepileptic seizures (PNES) are the most common Functional Neurological Disorder/Conversion Disorder subtype. Significant advances have been made related to diagnosis, neurobiology, and treatment. In this review, we summarize updates in diagnosis and management over the past 3 years. Recent Findings Although evidence is mixed for the treatment of PNES, psychotherapeutic modalities remain a powerful instrument to empower patients and reduce seizures. A multidisciplinary, holistic approach is beneficial. While seizure freedom in all patients may not be the achieved endpoint in this chronic, paroxysmal disorder, quality of life can be improved with treatment. Additional treatment modalities and further research are needed for patients who are refractory to current treatment. Evidence-based therapies exist for PNES, and recent findings represent an increased understanding of the clinical and neurophysiologic aspects of PNES.

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