Unmasking Psychogenic Non-Epileptic Seizures
Seizure-like episodes that are not caused by epilepsy present one of the most challenging diagnostic and therapeutic problems in modern neurology. Psychogenic Non-Epileptic Seizures (PNES), now understood within the broader framework of Functional Neurological Disorder, can closely resemble epileptic seizures while arising through different mechanisms. Accurate recognition requires more than identifying an abnormal movement pattern; it requires careful clinical reasoning, appropriate use of video-EEG, thoughtful differential diagnosis, and communication that preserves the patient's trust and dignity.
Psychogenic Non-Epileptic Seizures: From Brain Network Dysfunction to Diagnosis, Communication, and Recovery provides a clinically grounded examination of PNES from neurobiology through long-term care. It explores contemporary models of functional brain-network dysfunction, seizure semiology, diagnostic reasoning, electroclinical correlation, and the challenges of distinguishing functional seizures from epilepsy, syncope, sleep disorders, movement disorders, and other paroxysmal conditions.
Particular attention is given to the diagnostic encounter itself. The way PNES is explained can influence whether patients understand, accept, and engage with treatment. This book examines practical approaches to communicating the diagnosis without implying that symptoms are fabricated, imaginary, or voluntarily produced. It also addresses family responses, caregiver dynamics, healthcare-system factors, and the consequences of prolonged diagnostic uncertainty.
Treatment is approached through an evidence-based, multidisciplinary framework encompassing psychological therapies, functional rehabilitation, management of psychiatric and neurological comorbidities, appropriate use or withdrawal of antiseizure medications, and coordinated longitudinal care. Rather than defining success solely by seizure cessation, the discussion considers functional independence, participation in daily life, emotional regulation, occupational recovery, and quality of life.
The book also examines prognosis, factors associated with improvement or chronicity, the consequences of diagnostic delay, relapse and maintenance strategies, and complex presentations including coexisting epilepsy and PNES and presentations in younger patients.
Designed for clinicians seeking a practical yet scientifically informed approach, this guide connects modern neurobiological models with the realities of diagnosis and treatment. Its central focus is a clinically useful principle: functional seizures are real neurological symptoms, and effective care depends on recognizing the disorder accurately, explaining it clearly, and providing an appropriate pathway toward recovery.
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