Psychogenic non-epileptic seizures: what is neuropsychology showing us?

In December of 2012, the neuropsychology team from the Northeast Regional Epilepsy Group will present some interesting early findings about patients with psychogenic non-epileptic seizures as compared to patients with epilepsy.
The study compared executive functions (planning and organizing, problem solving, attention, working memory, mental flexibility, set shifting) in patients with psychogenic non-epileptic seizures (PNES) and temporal lobe epilepsy patients (TLE). In order to make sure that everyone who was included made a good effort we removed those who did not pass a test that looks at symptom exaggeration from our analysis.
Deficits in working memory and executive functioning have already been reported in patients with psychogenic seizures (Chapman et al., 2011). Other studies have also reported executive function and working memory deficits in temporal lobe epilepsy (Stretton J & Thompson PJ, 2012). We wanted to look at whether those with a diagnosis of PNES presented with problems in executive functioning that were similar to those with temporal lobe epilepsy. We thought they might but needed to verify it and in order to do it, we gave both groups of patients a battery of tests that assessed different types of executive functioning. We had 97 patients with PNES and 89 patients with temporal lobe epilepsy.
We found that a similarly large number of patients with psychogenic non-epileptic seizures and temporal lobe epilepsy had weaknesses on tests of executive function. Eighteen to 23 percent of patients with PNES and 22 to 30 percent of patients with temporal lobe epilepsy earned below normal scores on all three executive function subtests. These findings are intriguing and support that future studies to continue to explore these issues and new studies to check that this finding comes up again are needed. Future research should also explore what might be contributing to these problems in both of these patient groups.
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5 thoughts on “Psychogenic non-epileptic seizures: what is neuropsychology showing us?”

    1. So would I JoAnn, my husband was diagnosed a year and a 1/2 ago and we still have Very, Very few answers. We haven’t received the best of care from the health care professionals either. So far it’s been a nightmare. When we ask ANY questions, we have the psychiatrists telling us it’s not their area of expertise to ask the neurologist so we ask the neurologists, who also tells us it’s not his area of expertise to ask the psychiatrist. We feel like a ping-pong ball. We’ve asked our family physician, University doctor’s, psychologists’, counselors’, etc…, and they also, have NO answers. We weren’t even offered a “treatment plan” from the diagnosing neurologist. most of the doctors we’ve dealt with have no idea what PNES really is. I know it’s only been a few months for you but I hope you are receiving much better care than we did… and I pray the delivery of the diagnoses wasn’t nearly as damaging to you as our was to us. Praying for you, praying for all of us going through this.

  1. Crystal Ramos

    I hypothesize that the deficits in working memory and executive function derive from impact trauma caused by the seizures. That trauma remains consistent for both groups.

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