Title Psychogenic nonepileptic seizures Title (croatian) Psihogeni ne-epileptički napadaji Author Christina Cosic Mentor Željka Petelin Gadže (mentor)Committee member Željka Petelin Gadže (predsjednik povjerenstva)Committee member Mario Habek (član povjerenstva)Committee member Zdravka Poljaković (član povjerenstva)Granter University of Zagreb Defense date and country 2018-10-23, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract PNES are psychologically derived paroxysmal events which commonly present in early
adulthood, occur more often in woman, and can appear clinically similar to a number of
other neurological disorders. Events can include variable and non-stereotypical features,
with a duration of seconds to minutes. It is known that certain epilepsy syndromes can
present without clear epileptiform changes, and this adds to the difficulty in accurate
diagnosis of PNES.
Accurate and timely diagnosis of PNES is paramount to the health and well-being of the
patient. Video EEG is important not only as a diagnostic tool in PNES, but also in
facilitating patient acceptance of the diagnosis, and compliance towards the
recommended therapy. Misdiagnosis remains an important issues in PNES, and serious
steps need to be taken to minimize this occurrence in the PNES community.
Misdiagnosis leads to burden to both the patient and the health care system, resulting in
unnecessary hospital stays, and interventions.
More than half of patients with PNES suffer from one or more comorbidities. Timely
and accurate diagnosis of PNES, allows for a treatment plan of the patient’s
comorbidities, which can improve overall psychological well-being and functioning of
the patient. Treatment options of PNES are limited, with psychological therapy being
first line treatment.
The purpose of this paper is to give a general overview of PNES, the clinical aspects of
the events, the diagnostic and treatment challenges, it’s comorbidities, therapy, with
emphasis on the importance of early recognition and accurate diagnosis in improving
long term outcome in the patient.
Abstract (croatian) PNES su psihogeni ne-epileptički napadaji koji mogu izgledati slično epileptičkim
napadajima, ali se smatraju ne-epileptički po naravi, zbog nedostatka epileptiformne
aktivnosti na EEG-u. Za razliku od epilepsije, smatra se da su PNES izazvani stresom, s
psihološkim porijeklom. Dijagnoza PNES-a počiva na kombinaciji povijesti pacijenata,
kliničkih opservacija i video EEG nalaza. Video EEG igra ključnu ulogu u dijagnozi
PNES-a i na kraju poboljšava pacijentovo prihvaćanje dijagnoze PNES-a i prihvaćanje
terapije. Pogrešna dijagnoza je česta i problematičan izazov u PNES-u, a značajno
kašnjenje u dijagnozi se često događa kod bolesnika. To predstavlja ozbiljan problem, ne
samo sa strane neliječenja ili pogrešnog liječenja bolesti koje dolaze s pogrešnom
dijagnozom / nedostatkom dijagnoze, ali i sa nepraćenjem bolesti što je uobičajeno u
PNES-u. Pogrešna dijagnoza PNES-a i dalje dovodi do opterećenja pacijentu i
zdravstvenom sustavu, što rezultira nepotrebnim primanjem u bolnice te dijagnostičkim i
terapijskim intervencijama.
Ispravna i brza dijagnoza PNES-a omogućuje bolju prognozu i poboljšanu psihološku i
društvenu dobrobit pacijenta. Još se uvijek dugoročne prognoze PNES-a nisu pokazale
povoljne, jer mnogi bolesnici i dalje pate od napadaja usprkos terapiji. Psihološka
terapija, s naglaskom na prepoznavanje uzroka i poučavanja upravljanja stresom, smatra
se terapijom prvog reda u upravljanju PNES-om. Svrha ovog rada je dati opći pregled
PNES-a, njegovih komorbiditeta, stalnih dijagnostičkih izazova povezanih s ovim
stanjem, te mogućnosti liječenja, s naglaskom na važnost ranog prepoznavanja i točnu
dijagnozu u poboljšanju dugoročnog ishoda bolesnika.
Keywords
Psychogenic nonepileptic seizures
EEG
comorbidity
conversion disorder
Keywords (croatian)
psihogeni ne-epileptički napadaji
EEG
komorbiditet
konverzivni poremećaj
Language english URN:NBN urn:nbn:hr:105:666706 Study programme Title: Medicine (in English language) Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-07-22 09:26:27
