Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force
Date
2018
Type:
Article
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Abstract
Objective: Studies from a small number of countries suggest that patients with
psychogenic nonepileptic seizures (PNES) have limited access to diagnostic and
treatment services. The PNES Task Force of the International League Against
Epilepsy (ILAE) carried out 2 surveys to explore the diagnosis and treatment of
PNES around the world.
Methods: A short survey (8 questions) was sent to all 114 chapters of the ILAE.
A longer survey (36 questions) was completed by healthcare professionals who
see patients with seizures. Questions were separated into 5 sections: professional
role, diagnostic methods, management, etiology, and access to health care.
Results: Responses were received from 63 different countries. The short survey
was completed by 48 ILAE chapters, and the long survey by 1098 health profes-
sionals from 28 countries. PNES were recognized as a diagnostic and therapeutic
problem in all countries. Trauma and mental health issues were most commonly
recognized as etiologic factors. There was a clear relationship between income
and access to diagnostic tests and expertise. Psychological therapy was most com-
monly considered the treatment of choice. Although financial difficulties were the
most commonly reported problem with service access in low-income countries, in all countries stigma, lack of popular awareness, and lack of information posed
challenges.
Significance: This global provider survey demonstrates that PNES are a health
problem around the world. Health care for PNES could be improved with better
education of healthcare professionals, the development of reliable and simple
diagnostic procedures that do not rely on costly tests, and the provision of acces-
sible information.
Description
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Citation
Hingray C, El-Hage W, Duncan R, Gigineishvili D, Kanemoto K, LaFrance WC Jr, de Marinis A, Paul R, Pretorius C, Téllez-Zenteno JF, Wiseman H, Reuber M. Access to diagnostic and therapeutic facilities for psychogenic nonepileptic seizures: An international survey by the ILAE PNES Task Force. Epilepsia. 2018 Jan;59(1):203-214. doi: 10.1111/epi.13952.
Keywords
Diagnostic methods, Dissociation, Psychogenic nonepileptic seizures, Psychopathology, Therapeutic strategies