Adults with psychogenic non-epileptic seizures (PNES)
Patients can experience seizures that closely resemble epileptic seizures but are not actually epilepsy. These seizures do not show electrical discharges in the brain, nor are there other bodily malfunctions, such as those seen with fainting or heart rhythm disturbances. However, the seizures may appear identical to epileptic seizures. In most cases, there is an emotional and/or psychosocial cause underlying the seizures. The specific factors vary widely, and often multiple causes play a role.
In many cases, individuals are not even aware of these factors and/or their impact. It can also be difficult for a doctor to distinguish so-called psychogenic non-epileptic seizures (PNES) from epileptic seizures. The situation becomes even more complicated if someone has both epileptic and psychogenic non-epileptic seizures.
Diagnosis and (further) treatment
At Kempenhaeghe, a specialized team treats adults and children with psychogenic non-epileptic seizures (PNES). This team assists in properly diagnosing the condition and discusses the available options for (further) treatment. Treatment is preferably provided in the patient's home environment.
Since the cause of the seizures is very different from that of epileptic seizures, it is understandable that medications for epilepsy do not help with PNES. For patients already taking anti-epileptic drugs - who do not have a combination of epileptic seizures and PNES - the neurologist typically chooses to gradually reduce anti-epileptic medications. The underlying causes of PNES can vary significantly from patient to patient, which means there is no standard treatment for PNES.
Outpatient treatment or short-term admission
It may happen that PNES significantly decrease after the diagnosis, making further treatment unnecessary. However, in most cases, the search for the best approach requires substantial effort and cooperation from both the patient and their immediate environment. This search and the approach itself typically take place on an outpatient basis.
In exceptional cases, it may be beneficial to admit the patient for a short stay in the epilepsy clinic. The goal of this admission is not directly aimed at stopping the seizures, but rather at learning to cope with them. Addressing the underlying emotional issues will continue after the admission.
Referral for long-term treatment
For long-term treatment of the underlying causes of PNES, a referral is often necessary to, for example, a private psychologist, general social work, or mental health care services. Naturally, Kempenhaeghe ensures careful transfer of care in such cases.