Psychogenic Non Epileptic Seizures (PNES)

In Arthur Janov's  blog he makes the following reflection:

"Hello everyone,

Someone just sent me a book called "Healing Fits" by Robert Reese which explains how primal solved his epilepsy. I forgot reading it years ago and worse, I forgot writing its preface. It is a good read about how primal works. This is way back. Of those epileptics who come to us we have been very successful but I never tout our therapy as a cure for epilepsy. I think we lower the stress level to below where symptoms appear. This is borne out by our research on the stress hormone cortisol which is lowered in our therapy.  Art Janov."

As a party concerned, I made the following comments (1) and referred to an official information (2) from a university in the United States.

1. 

Hi Art,

In your comments re. “Healing Fits” you mention that epileptics who have come to you have been very successful due to a lowering of the stress level to below where symptoms appear. However,  I think that many of those, who have been diagnosed epileptics, have been misdiagnosed. Many of them were actually not epileptics. They had PNES (Psychogenic Nonepileptic Seizures). See enclosed definition from a university hospital in Texas. (Why not establish a contact with them. Their diagnosis seems utterly interesting.)

2.

Psychogenic Non Epileptic Seizures

Epileptic seizures are defined as a sudden change in perception or behavior associated with an electrical discharge that synchronizes the nerve cells in the surface of the brain. Patients with epileptic seizures frequently have abnormal electrical markers for a risk of seizures on electroencephalograms (EEG). But not all behaviors that resemble seizures are actually epileptic. Some people may demonstrate brief convulsive movements when they faint, raising the suspicion of seizure activity. The most common causes are seizures that are not epileptic are emotional stress, conflicts and traumatic psychological experiences. Psychogenic non-epileptic seizures (PNES) are frequently associated with unresponsiveness or even convulsive activity, symptoms which are typically exhibited by epileptic seizures. 

PNES are very commonly misdiagnosed as epilepsy. PNES are common, 10-40 percent of patients referred to epilepsy centers have PNES. The most reliable test to make the diagnosis is video-EEG monitoring. Patients are commonly admitted to an epilepsy monitoring unit, where they are taken off seizure medications, and monitored with simultaneous video and EEG recording. PNES are diagnosed when seizures are recorded without any change of the EEG activity. PNES can be diagnosed with nearly 100 percent reliability by video-EEG monitoring.

It is important to emphasize that PNES are disabling, and that people with PNES are not pretending or faking the symptoms. Frequently patients with PNES have others psychiatric co-morbidities, most commonly mood and anxiety disorders. The most important intervention is a psychiatric evaluation in order to assess the need for psychotherapy or medical treatment. Early diagnosis of PNES is critical to avoid delays in treatment and exposure to unnecessary medications with serious negative side effects. With the appropriate treatment, the PNES can resolve.

http://www.universityhealthsystem.com/all-locations/

Jan Johnsson