Psychogenic nonepileptic seizures. Theoretic and clinical considerations

The psychogenic nonepileptic seizure (PNES) is a common problem that occurs in 10% to 20% of children and 10% to 58% of adults referred to epilepsy centers. Despite the high prevalence of this condition, the magnitude of this public health problem and its impact on quality of life are not appreciated. Moreover, there is no clear consensus regarding classification, diagnosis, or management of PNES. Therefore, this article reviews the current literature on the clinical and theoretical aspects of PNES. Design/Method: The medical literature was reviewed for all articles pertaining to pathophysiology, diagnosis, and treatment of PNES. Results: Epidemiology, etiology, and diagnosis, and the use of diagnostic tests (including electroencephalogram and laboratory tests) are discussed. Current therapies and their efficacies are presented as well. Conclusions: Psychogenic nonepileptic seizures are much more common than previously known. There are several clinical and laboratory tools that may aid in confirming the diagnosis of PNES. Despite the advances in the diagnosis of PNES, there is no clear agreement as to the best treatment plan for PNES patients.