• Clinical and Experimental Pediatrics
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• v.64 no.6
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• pp.251-259
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• 2021

Psychogenic nonepileptic seizures (PNES) is a neuropsychiatric condition that causes a transient alteration of consciousness and loss of self-control. PNES, which occur in vulnerable individuals who often have experienced trauma and are precipitated by overwhelming circumstances, are a body's expression of a distressed mind, a cry for help. PNES are misunderstood, mistreated, under-recognized, and underdiagnosed. The mind-body dichotomy, an artificial divide between physical and mental health and brain disorders into neurology and psychiatry, contributes to undue delays in the diagnosis and treatment of PNES. One of the major barriers in the effective diagnosis and treatment of PNES is the dissonance caused by different illness perceptions between patients and providers. While patients are bewildered by their experiences of disabling attacks beyond their control or comprehension, providers consider PNES trivial because they are not epileptic seizures and are caused by psychological stress. The belief that patients with PNES are feigning or controlling their symptoms leads to negative attitudes of healthcare providers, which in turn lead to a failure to provide the support and respect that patients with PNES so desperately need and deserve. A biopsychosocial perspective and better understanding of the neurobiology of PNES may help bridge this great divide between brain and behavior and improve our interaction with patients, thereby improving prognosis. Knowledge of dysregulated stress hormones, autonomic nervous system dysfunction, and altered brain connectivity in PNES will better prepare providers to communicate with patients how intangible emotional stressors could cause tangible involuntary movements and altered awareness.

• The Journal of the Society of Stroke on Korean Medicine
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• v.22 no.1
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• pp.11-20
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• 2021

Psychogenic Non Epileptic Seizure (PNES) refers to a case in which symptoms are similar to epileptic seizures (ES), but ES do not appear in EEG and temporary abnormalities caused by physical diseases are also excluded. Psychotherapy and pharmacotherapy are most commonly used, but standard treatment for PNES has not been established and there is no alternative treatment available in the case of patients those treatments are not applied. We herein report a case of 46 year old male diagnosed with PNES who suffered from generalized tonic-clonic seizures. The patient underwent korean medical treatment by acupuncture and herbal medicine. The clinical symptom was evaluated by assessing occurrence frequency, number of seizures per 28 days. Compared to the period without korean medical treatment, the number of seizures decreased during the treatment period. The present case report suggested that korean medical treatment could be an effective option for those PNES patients complaining generalized tonic-clonic seizures.

• Clinical and Experimental Pediatrics
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• v.51 no.1
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• pp.62-66
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• 2008

Purpose : In addition to epileptic seizures (ES), a variety of physiologic, organic and psychogenic disorders can manifest as paroxysmal behavioral events. Paroxysmal nonepileptic events (PNEs) are quite encountered in infants, young children, and adolescents. In a substantial proportion of cases, a careful history and examination will elucidate their nature. However, in other cases, it is necessary to differentiate PNEs from ES by video-electroencephalographic (EEG) monitoring. We report our experiences with PNEs in a group of children and adolescents who underwent video-EEG monitoring. Methods : From September, 2004 to June, 2006, one hundred thirty patients were monitored in the Pediatric Epilepsy Monitoring Units of Korea University Guro and Ansan hospitals. Their hospital charts were reviewed and video records of these events were analyzed. We observed all patients after video-EEG monitoring for more than 3 months. Results : Typical spells occurred during monitoring in 33 patients, not associated with a seizure pattern on EEG recordings. Two patients were diagnosed as frontal lobe epilepsy on basis of typical semiology and clinical characteristics, so 31 patients were documented to have PNEs finally. The mean age of patients was $7.2{\pm}5.8\;years$. The male to female ratio was 15 (48.4%) to 16 (51.6%). Among 31 patients, fifteen patients had associated disorders such as epilepsy, developmental delay, cerebral palsy, gastric ulcer, attention deficit hyperactivity disorder or depressive disorder. Somatoform disorder and factitious disorder was frequently seen in children more than 5 years old (P<0.05). Psychogenic disorder was more frequent in female (n=6) than in male (n=2) but there was no statistical significance (P>0.05). Conclusion : Our study suggests that video-EEG monitoring is an important diagnostic tool in the evaluation of paroxysmal behavioral events. With correct diagnosis of the PNEs, several unnecessary treatment could be avoided.

• The Journal of the Society of Stroke on Korean Medicine
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• v.21 no.1
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• pp.33-38
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• 2020

■ Objectives This case report is reported to show the effect of Ukgansan and Hwangnyeonhaedok-tang on a patient who complaining myoclonic seizure due to psychogenic non epileptic seizure, occurred after traumatic stress event. ■ Methods A female patients with myolconic seizure was treated with Ukgansan and Hwangnyeonhaedok-tang during 5 days. Then we assessed dyskinesia severity by AIMS(Abnormal Involuntary Movement Scale) every two days til discharge. ■ Results Seizure decreased two days after hospitalization, then disappeared third day. There was no recurrence till discharge. When she revisited outpatients clinic, there was no symptom. ■ Conclusion This case showed the effect of Ukgansan and Hwangnyeonhaedok-tang on psychogenic epileptic seizure.