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Psychiatric Classification of Nonconversion Nonepileptic Seizures

Psychiatric Classification of Nonconversion Nonepileptic Seizures Abstract Episodic changes in behavior or consciousness that mimic epilepsy yet have no obvious organic cause have been variably referred to as nonepileptic seizures (NES), pseudoseizures, psychogenic seizures, nonconvulsive psychogenic attacks, and hysterical fits.1-6 They encompass a whole range of motor, sensory/experiential, and emotional manifestations. These phenomena are ubiquitously defined by being observable and without electroencephalographic correlates before, during, or after their occurrence. Alper and coworkers1 define two groups of patients with NES: one group satisfies the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition7 (DSM-III-R) criteria for conversion disorder; the other meets the criteria for an Axis 1 DSM-III-R syndrome other than conversion disorder. In this latter group, patients have episodes of anxiety, psychosis, or impaired impulse control. The challenge to clinicians now is to address the issues of pathogenesis and treatment in the context of abnormal biological functioning of the brain. One possibility References 1. Alper K, Devinsky O, Perrine K. Psychiatric classification of nonconversion nonepileptic seizures . Arch Neurol . 1995;52:199-201.Crossref 2. Roy A. Nonconvulsive psychogenic attacks investigated for temporal lobe epilepsy . Comp Psychiatry . 1977;18:591-593.Crossref 3. Gulick TA, Spinks IP, King DW. Pseudoseizures: ictal phenomena . Neurology . 1982;32:24-29.Crossref 4. Meierkord H, Will B, Fish D, et al. The clinical features and prognosis of pseudoseizures diagnosed using video-EEG telemetry . Neurology . 1991;41: 1643-1646.Crossref 5. Leis AA, Ross RA, Summers AK. Psychogenic seizures: ictal characteristics and diagnostic pitfalls . Neurology . 1992;42:95-99.Crossref 6. Boon PA, Williamson PD. The diagnosis of pseudoseizures . Clin Neurol Neurosurg . 1993;95:1-8.Crossref 7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition. Washington, DC: American Psychiatric Association; 1987. 8. Bear DM. Temporal lobe epilepsy: a syndrome of sensory-limbic hyperconnection . Cortex . 1979;15:357-384.Crossref 9. Flor-Henry P. On certain aspects of the localization of cerebral systems regulating and determining emotion . Biol Psychiat . 1979;14:677-698. 10. Sherwin I, Peron-Magnan P, Bancaud J, Bonis A, Talairach J. Prevalence of psychosis and epilepsy as a function of the laterality of the epileptogenic lesion . Arch Neurol . 1982;39:621-625.Crossref 11. Mark VH, Sweet WH. The role of limbic brain dysfunction in aggression . Res Publ Assoc Res Nerv Ment Dis . 1974;52:186-200. 12. Herzog AG. Perimenopausal depression: possible role of anomalous brain substrates . Brain Dysfunction . 1989;2:146-154. 13. Geschwind N, Galaburda AM. Cerebral lateralization: biological mechanisms, associations and pathology, II: a hypothesis and a program for research . Arch Neurol . 1985;42:521-552.Crossref 14. Sawyer CH. Functions of the amygdala related to the feedback actions of gonadal steroid hormones . In: Eleftheriou BE, ed. The Neurobiology of the Amygdala . New York, NY: Plenum Press; 1973:745-762. 15. Nicoletti F, Speciale C, Sortino MA, et al. Comparative effects of estradiol benzoate, antiestrogen clomiphene citrate, and progestin medroxyprogesterone acetate on kainic acid-induced seizures in male and female rats . Epilepsia . 1985;26:252-257.Crossref 16. Woolley DE, Timiras PS. The gonad-brain relationship: effects of female sex hormones on electroshock convulsions in the rat . Endocrinology . 1962;70: 196-209.Crossref 17. Post RM. Transduction of psychosocial stress into the neurobiology of recurrent affective disorder . Am J Psychiatry . 1992;149:999-1010. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Psychiatric Classification of Nonconversion Nonepileptic Seizures

Archives of Neurology , Volume 52 (11) – Nov 1, 1995

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1995.00540350030006
Publisher site
See Article on Publisher Site

Abstract

Abstract Episodic changes in behavior or consciousness that mimic epilepsy yet have no obvious organic cause have been variably referred to as nonepileptic seizures (NES), pseudoseizures, psychogenic seizures, nonconvulsive psychogenic attacks, and hysterical fits.1-6 They encompass a whole range of motor, sensory/experiential, and emotional manifestations. These phenomena are ubiquitously defined by being observable and without electroencephalographic correlates before, during, or after their occurrence. Alper and coworkers1 define two groups of patients with NES: one group satisfies the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition7 (DSM-III-R) criteria for conversion disorder; the other meets the criteria for an Axis 1 DSM-III-R syndrome other than conversion disorder. In this latter group, patients have episodes of anxiety, psychosis, or impaired impulse control. The challenge to clinicians now is to address the issues of pathogenesis and treatment in the context of abnormal biological functioning of the brain. One possibility References 1. Alper K, Devinsky O, Perrine K. Psychiatric classification of nonconversion nonepileptic seizures . Arch Neurol . 1995;52:199-201.Crossref 2. Roy A. Nonconvulsive psychogenic attacks investigated for temporal lobe epilepsy . Comp Psychiatry . 1977;18:591-593.Crossref 3. Gulick TA, Spinks IP, King DW. Pseudoseizures: ictal phenomena . Neurology . 1982;32:24-29.Crossref 4. Meierkord H, Will B, Fish D, et al. The clinical features and prognosis of pseudoseizures diagnosed using video-EEG telemetry . Neurology . 1991;41: 1643-1646.Crossref 5. Leis AA, Ross RA, Summers AK. Psychogenic seizures: ictal characteristics and diagnostic pitfalls . Neurology . 1992;42:95-99.Crossref 6. Boon PA, Williamson PD. The diagnosis of pseudoseizures . Clin Neurol Neurosurg . 1993;95:1-8.Crossref 7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition. Washington, DC: American Psychiatric Association; 1987. 8. Bear DM. Temporal lobe epilepsy: a syndrome of sensory-limbic hyperconnection . Cortex . 1979;15:357-384.Crossref 9. Flor-Henry P. On certain aspects of the localization of cerebral systems regulating and determining emotion . Biol Psychiat . 1979;14:677-698. 10. Sherwin I, Peron-Magnan P, Bancaud J, Bonis A, Talairach J. Prevalence of psychosis and epilepsy as a function of the laterality of the epileptogenic lesion . Arch Neurol . 1982;39:621-625.Crossref 11. Mark VH, Sweet WH. The role of limbic brain dysfunction in aggression . Res Publ Assoc Res Nerv Ment Dis . 1974;52:186-200. 12. Herzog AG. Perimenopausal depression: possible role of anomalous brain substrates . Brain Dysfunction . 1989;2:146-154. 13. Geschwind N, Galaburda AM. Cerebral lateralization: biological mechanisms, associations and pathology, II: a hypothesis and a program for research . Arch Neurol . 1985;42:521-552.Crossref 14. Sawyer CH. Functions of the amygdala related to the feedback actions of gonadal steroid hormones . In: Eleftheriou BE, ed. The Neurobiology of the Amygdala . New York, NY: Plenum Press; 1973:745-762. 15. Nicoletti F, Speciale C, Sortino MA, et al. Comparative effects of estradiol benzoate, antiestrogen clomiphene citrate, and progestin medroxyprogesterone acetate on kainic acid-induced seizures in male and female rats . Epilepsia . 1985;26:252-257.Crossref 16. Woolley DE, Timiras PS. The gonad-brain relationship: effects of female sex hormones on electroshock convulsions in the rat . Endocrinology . 1962;70: 196-209.Crossref 17. Post RM. Transduction of psychosocial stress into the neurobiology of recurrent affective disorder . Am J Psychiatry . 1992;149:999-1010.

Journal

Archives of NeurologyAmerican Medical Association

Published: Nov 1, 1995

References