Psychogenic non-epileptic seizures: a model of their pathogenic mechanism
Open accessAbstract
Psychogenic non-epileptic seizures (PNES) consist of paroxystic events facilitated by a dysfunction in emotion processing. Models explaining the pathogenic mechanisms leading to these seizure-like episodes are limited. In this article, evidence that supports dysfunction at the level of arousal tolerance, cognitive-emotional information processing and volitional control is reviewed. A hypothetical pathophysiological mechanism is discussed based on functional neuroimaging evidence from PNES-related conditions and traits. This pathophysiological model suggests an alteration in the influence and connection of brain areas involved in emotion processing onto other brain areas responsible for sensorimotor and cognitive processes. Integrating this information, PNES are conceptualized as brief episodes facilitated by an unstable cognitive-emotional attention system. During the episodes, sensorimotor and cognitive processes are modified or not properly integrated, allowing the deployment of autonomous prewired behavioral tendencies. Finally, I elaborate on how therapeutic applications could be modified based on the proposed hypothetical model, potentially improving clinical outcomes.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Since FND is mechanistically and aetiologically heterogenous, a range of other mechanisms articulated in the field remain relevant.
“Lastly, since FND is mechanistically and aetiologically heterogenous, a range of other mechanisms articulated in the field remain relevant.8,22,23,[26][27][28][29]”
From A new science of emotion: implications for functional neurological disorder (2022) · cites this paper as [22]
The Conclusion describes several possible pathogenic mechanisms and different combinations of vulnerabilities in psychogenic non-epileptic seizures (PNES). Section 2.1.4 also says PNES episodes may involve multiple mechanisms and may or may not relate to past trauma. This supports mechanistic and aetiological heterogeneity for PNES, but the paper does not establish the claim for FND as a whole. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 163 · Cited by 214
Research works printed but not linked: 4
- [81]81. Lane RD, Schwartz GE. Levels of emotional awareness: a cognitive-develop- mental theory and its application to psychopathology. Am J Psychiatry 1987;144:133-43.
- [87]87. Beere DB. The self-system as a mechanism of the dissociative disorders: an extension of the perceptual theory of dissociation. In: Dell P, O'Neil J, editors. Dissociation and the dissociative disorders: DSM-V and beyond. New York: Routledge; 2009. p. 277-86.
- [90]90. Spence SA. The cognitive executive is implicated in the maintenance of psychogenic movement disorders. In: Hallett M, Fahn S, Jankovic J, Lang AE, Cloninger CR, Yudofsky SC, editors. Psychogenic movement disorders: neurology and neuropsychiatry. Philadelphia: Lippincott Williams and Wilkins; 2006. p. 222-9.
- [158]158. Gold SN, Seibel SL. Treating dissociation: a contextual approach. In: Dell P, O'Neil J, editors. Dissociation and the dissociative disorders: DSM-V and beyond. New York: Routledge; 2009. p. 625-36.
- Authors
- Baslet, G.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Baslet, Gaston
- ORCID
- Baslet, Gaston
- Venue
- Seizure
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 20
- Issue
- 1
- Pages
- 1-13
- ISSN
- 1059-1311 (ISSN-L)
- OpenAlex
- W2003500282
- Semantic Scholar
- 1111b914a9f0f62fa10a9cb3a7fecfe476786cc1
- Cited by
- 214
- References
- 163
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 10 · 2023: 13 · 2022: 10 · 2021: 16 · 2020: 15 · 2019: 13 · 2018: 17 · 2017: 23 · 2016: 16 · 2015: 17 · 2014: 16 · 2013: 10 · 2012: 10
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Seizure (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- psychogenic non-epileptic seizures, pathophysiological model, emotional processing, volitional control, sensorimotor integration, functional neuroimaging, therapeutic implications
- MeSH terms
- Arousal, Emotions, Humans, Psychophysiologic Disorders, Seizures, Somatoform Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
