UNRAVELING THE ENIGMA OF APPROACH TO DIAGNOSIS AND MANAGEMENT OF PSYCHOGENIC NON-EPILEPTIC  SEIZURES : LITERATURE REVIEW

Dhea Asih  Wulandari; Riri Gusnita Sari

doi:10.31004/prepotif.v8i1.25910

Authors

Dhea Asih Wulandari Faculty of Medicine, Tarumanagara University, Jakarta
Riri Gusnita Sari Neurology Department, KRMT Wongsonegoro Regional Hospital, Jawa Tengah

DOI:

https://doi.org/10.31004/prepotif.v8i1.25910

Keywords:

Psychogenic Non-Epileptic Seizures (PNES), Neurobiological Factors, Psychological Assessment

Abstract

Kejang Non-Epileptik Psikogenik (PNES) memadukan aspek neurobiologis dan psikologis, sehingga menimbulkan tantangan diagnostik dan pengobatan. Meskipun sering terjadi, penelitian masih kurang sehingga menyebabkan kesalahan diagnosis dan perawatan yang tidak memadai. Studi ini melakukan tinjauan literatur menyeluruh, memeriksa artikel, uji coba, dan meta-analisis dari 20 tahun terakhir mengenai penyebab, diagnosis, dan pengobatan PNES dari database seperti PubMed dan PsycINFO. Hal ini menekankan perlunya pendekatan multidisiplin, menggabungkan penilaian neurologis dan psikologis. Stres dan trauma sangat penting dalam perkembangan PNES, sehingga menyarankan psikoterapi dan, bila diperlukan, pengobatan. Tinjauan tersebut menunjukkan tidak adanya standar diagnostik dan pengobatan yang seragam, sehingga menyoroti perlunya penelitian lebih lanjut. Ini menganjurkan tim multidisiplin dan perawatan yang berpusat pada pasien untuk meningkatkan hasil. Pekerjaan di masa depan harus fokus pada pembuatan pedoman manajemen PNES yang terstandarisasi, mempromosikan perawatan komprehensif yang memenuhi kebutuhan spesifik pasien.

References

Anzellotti, F., Dono, F., Evangelista, G., Di Pietro, M., Carrarini, C., Russo, M., Ferrante, C., Sensi, S. L., & Onofrj, M. (2020). Psychogenic Non-epileptic Seizures and Pseudo-Refractory Epilepsy, a Management Challenge. Frontiers in Neurology, 11. https://doi.org/10.3389/fneur.2020.00461

Aybek, S., & Perez, D. L. (2022). Diagnosis and management of functional neurological disorder. BMJ, o64. https://doi.org/10.1136/bmj.o64

Balachandran, N., Goodman, A. M., Allendorfer, J. B., Martin, A. N., Tocco, K., Vogel, V., LaFrance, W. C., & Szaflarski, J. P. (2021). Relationship between neural responses to stress and mental health symptoms in psychogenic nonepileptic seizures after traumatic brain injury. Epilepsia, 62(1), 107–119. https://doi.org/10.1111/epi.16758

Baslet, G., Bajestan, S. N., Aybek, S., Modirrousta, M., D.Clin.Psy, J. P., Cavanna, A., Perez, D. L., Lazarow, S. S., Raynor, G., Voon, V., Ducharme, S., & LaFrance, W. C. (2021). Evidence-Based Practice for the Clinical Assessment of Psychogenic Nonepileptic Seizures: A Report From the American Neuropsychiatric Association Committee on Research. The Journal of Neuropsychiatry and Clinical Neurosciences, 33(1), 27–42. https://doi.org/10.1176/appi.neuropsych.19120354

Espinosa-Garcia, C., Zeleke, H., & Rojas, A. (2021). Impact of Stress on Epilepsy: Focus on Neuroinflammation—A Mini Review. International Journal of Molecular Sciences, 22(8), 4061. https://doi.org/10.3390/ijms22084061

Gilmour, G. S., MacIsaac, R., Subotic, A., Wiebe, S., & Josephson, C. B. (2021). Diagnostic accuracy of clinical signs and symptoms for psychogenic nonepileptic attacks versus epileptic seizures: A systematic review and meta-analysis. Epilepsy & Behavior, 121, 108030. https://doi.org/10.1016/j.yebeh.2021.108030

Gupta, R., Garg, D., Kumar, N., Singh, M. B., Shukla, G., Goyal, V., Pandey, R. M., & Srivastava, A. K. (2020). Psychiatric co-morbidities and factors associated with psychogenic non-epileptic seizures: a case–control study. Seizure, 81, 325–331. https://doi.org/10.1016/j.seizure.2020.05.007

Jones, M., Gaskell, J., & Lehn, A. (2021). Differentiating psychogenic nonepileptic seizures from epileptic seizures: An observational study of patients undergoing video-electroencephalography (VEEG) in Australia. Epilepsy & Behavior, 114, 107542. https://doi.org/10.1016/j.yebeh.2020.107542

Kholi, H., Bellier, A., & Vercueil, L. (2020). PNESSE 1: Psychogenic status and status epilepticus: Could they be distinguished retrospectively? A survey among neurologists. Epilepsy & Behavior, 102, 106665. https://doi.org/10.1016/j.yebeh.2019.106665

Lanzillotti, A. I., Sarudiansky, M., Lombardi, N. R., Korman, G. P., & D´Alessio, L. (2021). Updated Review on the Diagnosis and Primary Management of Psychogenic Nonepileptic Seizure Disorders. Neuropsychiatric Disease and Treatment, Volume 17, 1825–1838. https://doi.org/10.2147/NDT.S286710

Lehn, A., Watson, E., Ryan, E. G., Jones, M., Cheah, V., & Dionisio, S. (2021). Psychogenic nonepileptic seizures treated as epileptic seizures in the emergency department. Epilepsia, 62(10), 2416–2425. https://doi.org/10.1111/epi.17038

Liampas, A., Markoula, S., Zis, P., & Reuber, M. (2021). Psychogenic non-epileptic seizures (PNES) in the context of concurrent epilepsy – making the right diagnosis. Acta Epileptologica, 3(1), 23. https://doi.org/10.1186/s42494-021-00057-x

Nahvi, R. J., & Sabban, E. L. (2020). Sex Differences in the Neuropeptide Y System and Implications for Stress Related Disorders. Biomolecules, 10(9), 1248. https://doi.org/10.3390/biom10091248

Radmanesh, M., Jalili, M., & Kozlowska, K. (2020). Activation of Functional Brain Networks in Children With Psychogenic Non-epileptic Seizures. Frontiers in Human Neuroscience, 14. https://doi.org/10.3389/fnhum.2020.00339

Tolchin, B., Hirsch, L. J., & LaFrance, W. C. (2020). Neuropsychiatric Aspects of Epilepsy. Psychiatric Clinics of North America, 43(2), 275–290. https://doi.org/10.1016/j.psc.2020.02.002

Yeom, J. S., Bernard, H., & Koh, S. (2021). Myths and truths about pediatric psychogenic nonepileptic seizures. Clinical and Experimental Pediatrics, 64(6), 251–259. https://doi.org/10.3345/cep.2020.00892