How Can Neurologists Treat Psychogenic Nonepileptic Seizures?

Treatments, including CBT plus medication, have reduced seizures in randomized trials.

Neurology Reviews. 2017 December;25(12):5

November 29, 2017|Neurology Reviews

The research team is now examining neurocircuitry mechanisms of seizures with a recently funded multisite study of fMRI before and after treatment in patients with epilepsy or with PNES. Elements of the one-hour, CBT-informed psychotherapy sessions use different psychotherapeutic modalities, including motivational interviewing, interpersonal therapy, psychodynamic psychotherapy, distress tolerance, and psychoeducation about medications. Providers around the country, including neurologists, are being trained to deliver the intervention. “What we do is not rocket science. It is just good therapy,” Dr. LaFrance said.

—Jake Remaly

Suggested Reading

LaFrance WC Jr, Baird GL, Barry JJ, et al. Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial. JAMA Psychiatry. 2014;71(9):997-1005.

LaFrance WC Jr, Keitner GI, Papandonatos GD, et al. Pilot pharmacologic randomized controlled trial for psychogenic nonepileptic seizures. Neurology. 2010;75(13):1166-1173.

LaFrance WC Jr, Miller IW, Ryan CE, et al. Cognitive behavioral therapy for psychogenic nonepileptic seizures. Epilepsy Behav. 2009;14(4):591-596.

LaFrance WC Jr, Reuber M, Goldstein LH. Management of psychogenic nonepileptic seizures. Epilepsia. 2013;54 Suppl 1:53-67.

LaFrance Jr WC, Wincze JP. Treating Nonepileptic Seizures: Therapist Guide. New York, NY: Oxford University Press; 2015.

Reiter JM, Andrews D, Reiter C, LaFrance Jr WC. Taking Control of Your Seizures: Workbook. New York, NY: Oxford University Press; 2015.

Wyllie E, Friedman D, Lüders H, et al. Outcome of psychogenic seizures in children and adolescents compared with adults. Neurology. 1991;41(5):742-744.

Yadav A, Agarwal R, Park J. Outcome of psychogenic nonepileptic seizures (PNES) in children: A 2-year follow-up study. Epilepsy Behav. 2015;53:168-173.

Veterans Health Administration. Veterans and Epilepsy: Basic Training: Psychogenic Non-Epileptic Seizures [video]. YouTube. https://youtu.be/NlX-yNTX86w. Published February 27, 2017.