Podcast 650: PNES

<p><strong>Contributor:  Katie Sprinkel, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Psychogenic Non-Epileptic Seizures (PNES) are due to a psychogenic rather than an epileptic cause</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Despite common assumption, PNES are not always volitional </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">20-40% of those with PNES can also have true epileptic seizures 20-40%</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">True diagnosis requires a video EEG </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Characteristics of PNES include:</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Waxing and waning of the seizure intensity</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Eyes clenched shut</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Pelvic thrusting, rolling from side-to-side</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Ability to respond to verbal stimuli during the seizure </span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Ability to recall information during the seizure</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Weeping or stuttering</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Guarding the face on passive hand drop</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Characteristics of epileptic seizures:</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><