Non-Epileptic Seizures in Our Experience最新文献

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Neurologist, 50+ years’ experience, Germany 神经学家,50多年经验,德国
Non-Epileptic Seizures in Our Experience Pub Date : 2020-04-01 DOI: 10.1093/med/9780190927752.003.0070
M. Reuber, G. Rawlings, S. Schachter
{"title":"Neurologist, 50+ years’ experience, Germany","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0070","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0070","url":null,"abstract":"This chapter highlights the experience of a Neurologist with a patient diagnosed with Psychogenic Seizures during her training. The Neurologist was given the task to inform the patient about the diagnosis, but without any guidance on how to do it, the neurologist did not find the right words. The patient understood that it was all her own fault and that the Neurologist could do nothing for her. When the Neurologist left the room, the patient jumped out of the window and killed herself. For many years afterward, the Neurologist tried to avoid any contact with patients with this diagnosis, but in the long run, that was of course not possible. However, it turned out that this horrible event had sensitized the Neurologist against common attitudes toward these patients. The Neurologist understood how deadly serious their condition was and was scandalized when, at video conferences, Psychogenic Seizures habitually were joked and laughed about. Little distinction was made between dissociative conditions and malingering, and the patients were often treated as if they had been found out to have pretended to be genuinely ill but were not. In consequence, neurologists did not feel responsible for these patients and transferred them to psychiatrists. Psychiatrists, however, had little diagnostic experience with seizures and often disbelieved their psychogenicity.","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126808865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Therapist with PNES, USA 美国PNES治疗师
Non-Epileptic Seizures in Our Experience Pub Date : 2020-04-01 DOI: 10.1093/med/9780190927752.003.0093
M. Reuber, G. Rawlings, S. Schachter
{"title":"Therapist with PNES, USA","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0093","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0093","url":null,"abstract":"This chapter examines the personal experience of a Therapist with Psychogenic Non-Epileptic Seizures (PNES). As a Therapist in private practice, the Therapist strongly believed that to end the stigma of mental health conditions, she needed to own her own mental health disorders. The Therapist could not sit across from her clients every day and tell them not to be ashamed of their debilitating Anxiety, Depression, or Post-Traumatic Stress Disorder (PTSD) and yet hide her own mental illness from the world. As such, the therapist spoke openly on social media about mental health and her own journey, and the Therapist shared positive messages about the disorders she treated—that is, until the therapist’s own experience crossed over from the garden variety “Anxiety and Depression” that she saw every day into a much less widely known disorder, PNES. Then, the Therapist became less of a Therapist and more of a patient, trying to maintain some sort of sanity and perspective afforded to her from her years of training as a therapist.","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130452109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nurse, 30+ years’ experience, Germany 护士,30年以上经验,德国
Non-Epileptic Seizures in Our Experience Pub Date : 2020-03-01 DOI: 10.1093/med/9780190927752.003.0054
M. Reuber, G. Rawlings, S. Schachter
{"title":"Nurse, 30+ years’ experience, Germany","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0054","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0054","url":null,"abstract":"This chapter highlights the importance of how attendants accompany and support patients in seizure situations. One patient, in particular, found it helpful if attendants addressed her during her seizures and did not leave her alone. With prompting, she was able to ease the stiffening of her body and gradually relax. Often, seizures were followed by a short sleep. Afterward, it was possible to discuss the situation and how attendants had interacted with her during the seizure. The long time gaps in her recollection, which had previously always occurred due to the medications she had been given and which had been the cause of some of her uncertainty, could be avoided. Over time, the patient was able to take on a greater level of responsibility for herself.","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122859039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical Psychologist, 2 years’ experience, UK 临床心理学家,2年经验,英国
Non-Epileptic Seizures in Our Experience Pub Date : 2020-03-01 DOI: 10.1093/med/9780190927752.003.0032
M. Reuber, G. Rawlings, S. Schachter
{"title":"Clinical Psychologist, 2 years’ experience, UK","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0032","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0032","url":null,"abstract":"This chapter studies the experience of a Clinical Psychologist who has conducted some research with patients with Psychogenic Non-Epileptic Seizures (PNES) but has not worked therapeutically with this patient group. What struck the psychologist was the lack of understanding about the condition, among both patients and clinicians. Anxiety goes hand in hand with uncertainty. As a Psychologist, it can feel overwhelming to identify, make sense of, and address the underlying trauma and difficulties of an illness presenting so physically and so strongly within the body. Hopefully, the continued developments in research and clinical practice will help this patient population receive the help and support that is necessary for their recovery.","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123462652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychologist, 9 years’ experience, UK 心理学家,9年经验,英国
Non-Epileptic Seizures in Our Experience Pub Date : 2020-03-01 DOI: 10.1093/med/9780190927752.003.0095
M. Reuber, G. Rawlings, S. Schachter
{"title":"Psychologist, 9 years’ experience, UK","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0095","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0095","url":null,"abstract":"This chapter focuses on the experience of a Psychologist who has worked with a great number of people with functional difficulties and Psychogenic Non-Epileptic Seizures (PNES). Working with those with PNES is supposed to be “difficult.” It is a difficult condition to diagnose, difficult for medicine and health services to categorize, and difficult in terms of the feelings engendered in both patient and clinician. Importantly, and often forgotten, is that attacks are profoundly difficult for the person experiencing them as well as his or her family. Personally, the Psychologist did not feel much of that difficulty. The Psychologist has some psychoanalytic tendencies, and is therefore not overly committed to the idea that he can actually make people better, nor is the Psychologist overly put off by uncertainty Ultimately, the Psychologist is drawn to working with people whose problems frustrate easy etiology or resist incorporation into the clear pathways of the modern National Health Service.","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130598721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurologist, 20 years’ experience, India 神经学家,在印度有20年的经验
Non-Epileptic Seizures in Our Experience Pub Date : 2020-03-01 DOI: 10.1093/med/9780190927752.003.0077
M. Reuber, G. Rawlings, S. Schachter
{"title":"Neurologist, 20 years’ experience, India","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0077","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0077","url":null,"abstract":"This chapter addresses the experience of a Neurologist who works in outreach epilepsy clinics, which cater to underserved rural patients. There was one patient, in particular, who had had epileptic seizures early in life. The description of these seizures, however, was very different from those that had happened during one of the outreach clinics conducted. The entire emphasis in the description of these seizures was on how the boy had a steady stream of spit emerging from the corner of his mouth. The Neurologist then requested to see another seizure right from the beginning. Within twenty minutes, the boy started to have one of his “seizures.” The boy was lying comfortably, hands folded, eyes shut, and there was foaming saliva at the angle of his mouth. After a few minutes, he opened his eyes and stood up and looked expectantly at the Neurologist as if gauging if the Neurologist was satisfied or not. The Neurologist then explained to the father that the current events seemed to be non-epileptic and told the boy that these “seizures” were definitely going to stop now as he had visited the special clinic. Four weeks later, the boy had not had any more “seizures.”","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116620279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychotherapist, 7 years’ experience, UK 心理治疗师,7年经验,英国
Non-Epileptic Seizures in Our Experience Pub Date : 2020-03-01 DOI: 10.1093/med/9780190927752.003.0014
M. Reuber, G. Rawlings, S. Schachter
{"title":"Psychotherapist, 7 years’ experience, UK","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0014","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0014","url":null,"abstract":"This chapter shows how a psychotherapist treats the seizure as a form of communication. The job of the psychotherapist, then, is to help the person understand what it is he or she needs to say when there are no words to tell the story. Not only are there no words, but even if there were, those that matter would not hear them. Hence, there is no solution; no one must know the depths of the person’s distress or what has caused it, but keeping it locked inside is impossible. It leaks out, through shakes, tremors, convulsions, and dissociation. Sometimes the intolerable feelings that necessitate the escape are hidden even to the person him- or herself. The seizure helps defend the self, providing a necessary distance between body and mind. Learning to respect this took the psychotherapist longer than it should have; to appreciate that helping people to live more easily with their symptoms is sometimes the wisest way forward. However, to be able to really hear someone, to understand the language of the person’s seizures and symptoms, and to help the person change his or her experience as a result—that is what the psychotherapist aspires to do in this work.","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"68 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114106355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychiatrist, 6 years’ experience, Australia 精神科医生,6年经验,澳大利亚
Non-Epileptic Seizures in Our Experience Pub Date : 2020-03-01 DOI: 10.1093/med/9780190927752.003.0043
M. Reuber, G. Rawlings, S. Schachter
{"title":"Psychiatrist, 6 years’ experience, Australia","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0043","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0043","url":null,"abstract":"This chapter explores the challenge of working with patients with Non-Epileptic Seizures (NES), which starts with the very name—what to call it, whether it is reasonable to call a condition by what it is not. More challenging is when and if the patient has comorbid epilepsy. The next task is to inform the patient. Working in a tertiary hospital means that the majority of patients have already seen various specialists and the idea might not be completely new to them. However, this does not make the task any easier. If possible, having both the Psychiatrist and the Neurologist together to discuss the diagnosis for the first time can help. Often, the patients are astonished when a Psychiatrist talks to them about “stress seizures,” and they respond with, “But I am not stressed.” Of course, many patients cannot express their anxiety and transform it instead, hence their physical symptoms arise, which in this case are seizures. The saga of NES continues when the focus moves on to treatment, as many times patients need time to come to terms with the very first step of accepting the diagnosis.","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"177 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122964597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neurologist, 25 years’ experience, UK 神经学家,25年经验,英国
Non-Epileptic Seizures in Our Experience Pub Date : 2020-03-01 DOI: 10.1093/med/9780190927752.003.0001
M. Reuber, G. Rawlings, S. Schachter
{"title":"Neurologist, 25 years’ experience, UK","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0001","url":null,"abstract":"This chapter examines two stories of psychogenic non-epileptic seizures (PNES). These dramatic narratives demonstrate how physical and real the effects of PNES are on people’s lives. Both cases also show the impossibility of separating body from mind. Miss A.’s non-epileptic seizure in the recovery room may have been triggered by the sensations associated with waking from her anesthetic, but it is likely to have been prolonged by the sedative drugs she was given in the attempt to stop it. Meanwhile, Mister B.’s dissociative seizure disorder may well have been precipitated by the challenges associated with adjusting to the new diagnosis of epilepsy, but it may have been facilitated by the physical or functional changes in his brain associated with the epileptic seizures. The depression, which may have been physically or psychologically related to the development of his epilepsy or the antiepileptic drug treatment, probably made an etiological contribution to the non-epileptic seizures as well. What these cases also illustrate is how, in the treatment of patients with seizure disorders, listening and observing continue to be the key skills clinicians need as they try to manage conflicts between the need for action and uncertainties, which characterize so much of epileptological practice.","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132361748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychotherapist, 10+ years’ experience, UK 心理治疗师,10年以上经验,英国
Non-Epileptic Seizures in Our Experience Pub Date : 2020-03-01 DOI: 10.1093/med/9780190927752.003.0063
M. Reuber, G. Rawlings, S. Schachter
{"title":"Psychotherapist, 10+ years’ experience, UK","authors":"M. Reuber, G. Rawlings, S. Schachter","doi":"10.1093/med/9780190927752.003.0063","DOIUrl":"https://doi.org/10.1093/med/9780190927752.003.0063","url":null,"abstract":"This chapter looks at the importance of being able to explore Non-Epileptic Attacks (NEAs) with patients if or when they happen in therapy. This can be really helpful for a number of reasons. Patients may need the Psychotherapist to know what they experience and how difficult this is for them. Describing their symptoms just does not cut it. They may find something in therapy difficult, but rather than being able to articulate this, they have a dissociative attack. It may also be a test of whether the Psychotherapist will respond to their distress in the way they need. Sometimes, trying to find a way around patients’ defenses to help them make contact and experience healing can be exhausting. Nevertheless, the Psychotherapist is still able to support the patients to manage their dissociative process effectively.","PeriodicalId":273617,"journal":{"name":"Non-Epileptic Seizures in Our Experience","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121640976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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