HOW WELL DO WE COMMUNICATE THE DIAGNOSIS OF PSYCHOGENIC NONEPILEPTIC SPELLS
Abstract number :
2.160
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2009
Submission ID :
9869
Source :
www.aesnet.org
Presentation date :
12/4/2009 12:00:00 AM
Published date :
Aug 26, 2009, 08:12 AM
Authors :
F. Chaudhry, S. Gill, N. Bangalore-Vittal, P. Singh, Y. Song, N. Azar and Amir Arain
Rationale: Psychogenic nonepileptic seizures (PNES) are common cause of refractory spells. PNES are seen in 10 to 58% of adult patients with intractable spells. These seizures are often misdiagnosed and patients are at risk of receiving inappropriate medications for prolonged treatment periods or invasive intervention. Simultaneous video-EEG monitoring has allowed pseudoseizures to be effectively diagnosed. Once the diagnosis is established it is not taken easily by patients and long term follow up in these patients is poor. Methods: The study is being conducted in a eight-bed epilepsy monitoring unit. Data is being collected using a self administered 41 item Likert-style scaled questionnaire developed by EMU staff. The surveys are being given to patients with PNES after their typical spells were recorded during the video EEG monitoring. The questionnaires were given to the patient after the attending physician had communicated the diagnosis of PNES. The questionnaires had items specifically asking if the diagnosis was communicated clearly, intended to assess if patient has perceived the diagnosis correctly. Results: There were 24 females and 9 males. Seventeen patients had high school education while 13 patients had college education. Three patients (9%) were not satisfied with the diagnosis. Seven patients (21%) did not agree that PNES has a psychological cause. Six patients (18%) thought that diagnosis will not change the outcome. Ten patients (10%) thought that the EMU doctors had no clue of the cause of PNES. Fourteen patients (42%) thought that people perceive their spells as fake. Five patients (15%) thought that there was no hope for cure of their spells. Conclusions: Patients with PNES do not perceive the diagnosis of PNES correctly and this may result in poor outcome. Some patients with PNES continue to think that PNES diagnosis will not change the out and there is no hope for cure of their spells. Proper and through education about PNES may prevent this miscommunication and result in a better outcome.
Cormorbidity