Pediatric Psychogenic Non Epileptic Seizures

This volume describes the basics for short- and long-term treatment of Psychogenic Non-Epileptic Seizures (PNES) in children. The text acknowledges that the disorder, though rare and highly morbid, is treatable when it is not misdiagnosed. Given the limited diagnostic and clinical training offered to clinicians, this book aims to equip professionals with the tools needed to improve the poor quality of life of youth with PNES. The text begins by introducing the main features of the disorder and the problems involved in diagnosing PNES in children. It then describes techniques to overcome these problems in order to make a reliable and valid diagnosis of PNES, as well as provide feedback on the diagnosis and treatment plan. The last section describes the indications for cognitive behavior therapy for youth with PNES and suggested treatment paradigms. Incorporation of do’s and don’ts and their relevant clinical examples in all sections of the proposed guide provide the reader with skills and techniques. The book also includes an appendix with resources for parents, children, and school nurses and teachers, relaxation techniques for the child and parents, templates of letters for the child’s school about the condition and behavior management plan, templates of supporting letters from epileptologists and primary care physicians, CBT treatment paradigm, and information on individual supervision, workshops and webinars. Written by the few experts in this area, Pediatric Psychogenic Non-Epileptic Seizures is the ultimate guide for psychiatrists, psychologists, nurses, primary care physicians, neurologists, epileptologists, social workers, nurses, school counselors, and all medical professionals working with children experiencing seizures.

Psychogenic nonepileptic seizures (PNES) are clinical events resembling epileptic seizures but lacking abnormal cortical electrical discharges. They are involuntary manifestations of a psychological distress. PNES are less frequent in the pediatric population than in adults, they represent from 3.5 to 9% of patients admitted for prolonged video-EEG (PV-EEG). Diagnosis is rarely made on history only and PV-EEG is mandatory to obtain a definitive diagnosis. Children as young as 5 years can present with PNES. They are more frequent in girls except in school age children where boys are identically or more represented than girls. PNES can either present with subtle signs, even unresponsiveness, or prominent motor activity. Major differential diagnosis is absences, day dreaming, and complex partial seizures including hyperkinetic frontal seizures. PNES are usually rapidly registered during PV-EEG and provocative methods have not been thoroughly studied in children. Major risk factors are psychological stressors, such as school or family problems. Psychiatric conditions are less frequent than in adults though they should be looked for. Prognosis is better than in adults, and most children become PNES-free. There are no guidelines for treatment, however stressors should be addressed. In general, it should be clearly explained that PNES are not epileptic seizures.

This open access book sets out the stress-system model for functional somatic symptoms in children and adolescents. The book begins by exploring the initial encounter between the paediatrician, child, and family, moves through the assessment process, including the formulation and the treatment contract, and then describes the various forms of treatment that are designed to settle the child’s dysregulated stress system. This approach both provides a new understanding of how such symptoms emerge – typically, through a history of recurrent or chronic stress, either physical or psychological – and points the way to effective assessment, management, and treatment that put the child (and family) back on the road to health and well-being.

Psychogenic nonepileptic seizures (PNES) are attacks that mimic epileptic seizures, but are not caused by abnormal electrical discharges in the brain. Instead, PNES are typically considered involuntary expressions of distress, making diagnosis and treatment a challenge. Historically, patients are referred to neurologists who, after completing a diagnostic work up, refer patients to mental health professionals, including psychiatrists, for treatment. For a number of reasons, this transition of care between specialists is often not successful, and this impacts patient treatment and outcomes. Psychogenic Nonepileptic Seizures: Toward the Integration of Care offers new insights into the practical diagnostic and treatment challenges faced by clinicians who manage this condition. This book covers the different stages of care, from the initial evaluation to long-term outcomes, and highlights the need to work collaboratively to provide patients with comprehensive care and improved outcomes. It provides up-to-date evidence and shares clinical expertise for the management of this challenging diagnosis that requires the expertise of a multi-disciplinary team. The authors provide a new framework on how to conceptualize and manage this disorder to more effectively address the needs of patients.

This handbook offers a comprehensive review of cognitive behavioral therapy (CBT) for working in integrated pediatric behavioral health care settings. It provides research findings, explanations of theoretical concepts and principles, and descriptions of therapeutic procedures as well as case studies from across broad conceptual areas. Chapters discuss the value of integrated care, diversity issues, ethical considerations, and the necessary adaptations. In addition, chapters address specific types of pediatric conditions and patients, such as the implementation of CBT with patients with gastrointestinal complaints, enuresis, encopresis, cancer, headaches, epilepsy, sleep problems, diabetes, and asthma. The handbook concludes with important directions in research and practice, including training and financial considerations.Topics featured in this handbook include: Emotional regulation and pediatric behavioral health problems. Dialectical Behavior Therapy (DBT) for pediatric medical conditions. Pharmacological interventions and the combined use of CBT and medication. CBT in pediatric patients with chronic pain. CBT for pediatric obesity. CBT-informed treatments and approaches for transgender and gender expansive youth. Medical non-compliance and non-adherence associated with CBT. Training issues in pediatric psychology. The Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions is an essential resource for researchers and graduate students as well as clinicians, related therapists, and professionals in clinical child and school psychology, pediatrics, social work, developmental psychology, behavioral therapy/rehabilitation, child and adolescent psychiatry, nursing, and special education.

This book is designed to fill the information gap and provide essential knowledge about PNES and the tools necessary to take charge of it.

The primary aim of Treating Nonepileptic Seizures: Therapist Guide is to equip physicians, psychologists, therapists, nurses, and other practitioners with a validated, step-by-step treatment for psychogenic nonepileptic seizures (NES) that can improve the lives of patients with this disabling disorder. Patients with NES frequently present in neurology, psychiatry, psychology, and emergency departments. The disorder has been documented in the medical literature for centuries, and much is known about the phenomenology, seizure characteristics, psychiatric comorbidities, neuropsychological testing, and psychosocial aspects in NES. However, until recently, much less was known about the effective treatments of patients with psychogenic NES. This intervention provides guidance for clinicians in treating patients with NES and is designed to be used in conjunction with the patient workbook, Taking Control of Your Seizures. Session by session, the Workbook facilitates communication between treatment providers and individual patients with seizures. The authors' clinical experience with epilepsy and NES and research in developing the treatment approach for seizures directly informed the treatment model described. Many patients treated with the intervention have demonstrated improvements in seizures, symptoms, and quality of life.

Patients with nonepileptic seizures present in neurology, psychiatry, psychology and emergency departments. Although the disorder has been well documented in the medical literature and much is known about the nature and signs of the condition, much less has been written about its treatment and management. Gates and Rowan's Nonepileptic Seizures, third edition, takes a multidisciplinary approach to this neuropsychiatric disorder, building and branching from the prior editions, with a strong focus on management, to aid all clinicians in the diagnosis and treatment of both child and adult patients. With a DVD containing video material to supplement the differential diagnosis, patient characteristics and treatment sections, and with contributions from the leading authorities from around the world, this will be essential reading for physicians and psychologists, at all levels of training and experience, encountering patients with this complex brain-behavior disorder.