Psychogenic Nonepileptic Seizures

Overview

4.6 out of 5 (13 Reviews)

Credits

1.00

Post Assessment Questions

6

Start Date

1 Sep 2023

Last Review Date

25 Feb 2024

Expiration Date

31 Aug 2026

Estimated Time To Finish

60 Minutes


 
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Activity Description

Nonepileptic episodic events can be vexing for the patient, and they present considerable diagnostic and therapeutic challenges to neurologists, psychiatrists, and other healthcare practitioners. Broadly construed, nonepileptic episodic events are paroxysmal occurrences arising from a physiologic or psychogenic cause, resulting in alterations in behavior, experience, sensation, or movement.  Nonepileptic episodic events closely resemble so-called epileptic seizures. However, they are not caused by the excessive synchronous cortical electroencephalographic activity that defines epileptic seizures, nor are they associated with concomitant epileptiform abnormalities on electroencephalogram. Both physiologic and psychogenic origins are subsumed under the general term nonepileptic episodic events. The term "psychogenic nonepileptic seizures" (PNES) reinforces the idea that events are not epileptic seizures and may instead be of psychogenic origin. At the same time, PNES signals to the knowledgeable practitioner that the evaluation and management will be different than for similar-appearing events that do have "epileptic" origins. PNES and epilepsy can coexist.

In most cases, the skills of an epilepsy specialist with access to an epilepsy monitoring unit will be needed to confirm the PNES diagnosis. Diagnostic confirmation is necessary to avoid misdiagnosis and unnecessary treatments, some of which risk nontrivial harm. This activity reviews the differences between epileptic seizures and PNES and outlines an approach to prompt diagnostic confirmation and implementation of appropriate treatment strategies. This activity further highlights the role of the interprofessional team in caring for patients with PNES.


Target Audience

This activity has been designed to meet the educational needs of physicians, physician associates, nurses, pharmacists, nurse practitioners, and social workers.

Learning Objectives

At the conclusion of this activity, the learner will be better able to:

  • Differentiate elements of the history and the ictus that suggest psychogenic nonepileptic seizures versus those suggesting epilepsy.

  • Identify the necessary elements of history, physical examination, and testing that must be present to substantiate a diagnosis of psychogenic nonepileptic seizures.

  • Select the correct treatment strategies for psychogenic nonepileptic seizures and differentiate them from the usual treatment for epilepsy.

  • Apply interprofessional team strategies for improving care coordination and patient education to advance the treatment of psychogenic nonepileptic seizures and improve patient outcomes.

Disclosures

StatPearls, LLC requires everyone who influences the content of an educational activity to disclose relevant financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All relevant conflict(s) of interest have been mitigated. Hover over contributor names for financial disclosures. Others involved in planning this educational activity have no relevant financial relationships to disclose.

Commercial Support: This activity has received NO commercial support.

Continuing Education Accreditation Information

In support of improving patient care, StatPearls, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.


As a Jointly Accredited Organization, StatPearls, LLC is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. StatPearls, LLC maintains responsibility for this course. Social workers completing this course receive 1.00 continuing education credits.

Social Workers: StatPearls, LLC designates this continuing education activity for 1.00 ASWB ACE credit(s) for social workers. Social Workers should only claim credit commensurate with the extent of their participation in the activity.

Please consult your professional licensing board for information on the applicability and acceptance of continuing education credit for this activity.

Method of Participation and Credit

  1. Register for the activity.    
  2. Review the target audience, learning objectives, and disclosure information.
  3. Study the educational content of the enduring material.
  4. Choose the best answer to each activity test question. To receive credit and a certificate, you must pass the test questions with a minimum score of 100%.
  5. Complete the post-activity assessment survey.

If you have concerns regarding the CE/CME system, please contact support@statpearls.com.

Disclaimer

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Faculty may discuss investigational products or off-label uses of products regulated by the FDA. Readers should verify all information before employing any therapies described in this educational activity.

The information provided for this activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The information presented does not necessarily reflect the views of StatPearls or any commercial supporters of educational activities on statpearls.com. StatPearls expressly disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through a participant's misunderstanding of the content.

Unapproved Uses of Drugs/Devices: In accordance with FDA requirements, the audience is advised that information presented in this continuing education activity may contain references to unlabeled or unapproved uses of drugs or devices. Please refer to the FDA-approved package insert for each drug/device for full prescribing/utilization information.

Cancellation Policy: Please see the cancellation policy. StatPearls, LLC reserves the right to cancel any course due to unforeseen circumstances.

 

 
 

Reviews

Elyshia L. on 6/24/2021

Bibhu Prasad N. on 11/22/2021

Lisa R. on 2/4/2022

Chris K. on 1/30/2023

Harlan H. on 3/5/2023

Dr Jagveer S. on 5/14/2023

Chia-Chen W. on 6/13/2023

kathleen w. on 11/11/2023

Akshaya K. on 11/17/2023

James S. on 11/25/2023

Malani K. on 1/25/2024

Joseph S. on 3/11/2024

Likta N. on 5/17/2024

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