Cited by 404Psychosomatic Disorders and Their TreatmentsEpilepsy research and treatmentPain Management and Placebo Effect

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Psychogenic nonepileptic seizures: review and update

Reuber, Markus, Elger, Christian E.·2003·Epilepsy & Behavior

DOI 10.1016/s1525-5050(03)00104-5

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Abstract

The population incidence of psychogenic nonepileptic seizures (PNES) may be only 4% that of epilepsy, but many patients with PNES have a tendency to seek medical attention, and PNES make up a larger share of the workload of neurologists and emergency and general physicians. Although a great number of publications describe how PNES can be distinguished from epileptic seizures, it usually takes several years to arrive at this diagnosis, and three-quarters of patients (with no additional epilepsy) are treated with anticonvulsants initially. However, the management of PNES as epileptic seizures can lead to significant iatrogenic harm. Moreover, the failure to recognize the psychological cause of the disorder detracts from addressing associated psychopathology and enhances secondary somatization processes. This review provides an overview of studies of the diagnosis, etiology, treatment, and prognosis of PNES. Physicians should always consider PNES in the differential diagnosis of a seizure disorder. If a diagnosis of PNES is possible, or a diagnosis of epilepsy in doubt, a clear diagnostic categorization should be sought. This should involve the assessment of the patient by a physician versed in the diagnosis of seizure disorders and, in many cases, the documentation of a typical seizure by video-EEG. Outcome may be improved if the diagnosis is more actively sought, made earlier, and communicated more convincingly.

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Authors: Reuber, M., & Elger, C. E.
Affiliations: Royal Hallamshire Hospital (GB)
University of Bonn (DE)
Corresponding author: Reuber, Markus
ORCID: Reuber, Markus
Elger, Christian E.
Venue: Epilepsy & Behavior
Publisher: Elsevier BV
Published: 2003-06
Volume: 4
Issue: 3
Pages: 205-216
ISSN: 1525-5050 (ISSN-L)
DOI: 10.1016/s1525-5050(03)00104-5
OpenAlex: W2112340291
Cited by: 404
References: 188
Citations by year: 2026: 11 · 2025: 13 · 2024: 12 · 2023: 15 · 2022: 14 · 2021: 19 · 2020: 21 · 2019: 16 · 2018: 19 · 2017: 15 · 2016: 20 · 2015: 19 · 2014: 30 · 2013: 20 · 2012: 22
FWCI: 2.08
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Epilepsy & Behavior (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Clinical Neurology › Epilepsy research and treatment
Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords: psychogenic non-epileptic seizures, anticonvulsant therapy, iatrogenic injury, somatization, psychopathology, etiology, prognosis, delayed diagnosis
MeSH terms: Anticonvulsants, Anxiety Disorders, Diagnosis, Differential, Electroencephalography, Epilepsy, Humans, Terminology as Topic, Psychotherapy, Stress Disorders, Post-Traumatic, Neurocognitive Disorders

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Psychogenic nonepileptic seizures: review and update

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