PNES Mimics Epilepsy

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ATLANTA, Ga. (Ivanhoe Newswire) — Chronic anxiety can have a powerful impact on the body, causing severe headaches, digestive disorders, and a weakened immune system.  It can also be one cause of a little-known condition that mimics epilepsy, with some jarring side effects.

Thirty-three year old Gretchen Granados takes pleasure in spending time with her husband Jacob, and German shepherd Hans. Three years ago, moments like that were tough to come by. Gretchen was plagued with frequent seizures.

“Her eyes would start to flutter back and forth.  She would blink rapidly and then she would become limp,” her husband Jacob explained.

Gretchen told Ivanhoe “a lot of the time I knew what was going on but I could not make my body or my voice respond.”

For at least two years, she was given meds for anxiety and narcolepsy. Finally, the couple and their doctors thought maybe it was epilepsy, but the medications prescribed only made her condition worse.

After researching the symptoms, Jacob reached out to Professor Daniel Drone of Emory University, an expert in a little known condition called psychogenic non-epileptic seizures or PNES.

“It often occurs in people who have experienced trauma, so maybe they’ve developed a maladaptive way of dealing with the stress,” explained professor Drone.

In Gretchen’s case, it wasn’t one trauma, but a series of stressors, leaving a beloved taxing job as a Salvation Army pastor, new motherhood, and a move several states away.

“I refused to rest and slow down, and my body finally did it for me.” Gretchen recalled.

Gretchen completed a twelve week therapy and counseling program for PNES and the seizures began to lessen in frequency.

“Over the past six month to a year it’s been the old Gretchen again.” Jacob shared

Gretchen said “I feel like I’m the mother I want to be, the wife I want to be.”

According to the epilepsy foundation, as many as twenty or thirty percent of the people who seek treatment for intractable seizures they think are caused by epilepsy, are then diagnosed with PNES.

Contributors to this news report include: Cyndy McGrath, Producer; Roque Correa, Editor and Videographer.

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PNES MIMICS EPILEPSY
REPORT #2435

BACKGROUND:  Psychogenic non-epileptic seizures (PNES or NES) are branded by a loss or change in physical function minus a central nervous problem. This causes periods of physical activity or inactivity to resemble epileptic seizures. NES is related to mental health problems caused by stress and emotional conflicts, such as sexual or physical abuse, incest, death of a loved one, divorce, or other great loss or sudden change. A symptom of NES is psychogenic seizures, which are not caused by a physical ailment like other seizures. These symptoms typically appear at times of extreme distress and may be the body’s way of trying to alleviate anxiety. The change in physical activity also includes impaired or jerky movements, temporary blindness, loss of smell or touch, disturbances in coordination, tunnel vision and tingling sensations in the skin. Those with NES usually have only one symptom.  However, episodes could show in a different location or intensity in recurrence.

(Source: http://www.webmd.com/epilepsy/tc/nonepileptic-seizures-nes-topic-overview)

THE STUDY:   The treatment of NES varies with each person. The goal for treatment is to relieve the stress or emotional conflict that may be leading to the changes in physical conditions. This may include medicines, counseling, or specific life changes, such as a job change or assistance at home. Because NES is not caused by problems of the brain, medicines that treat epilepsy do not work for this type of condition. But so far, the most effective treatment for PNES is a therapeutic technique called Eye Movement Desensitization and Reprocessing (EMDR). EMDR uses psychodynamic, cognitive behavioral, interpersonal, experiential and body-centered therapies to treat the condition. The process is sequential doses of past and present experiences while focusing on an external stimulus at the same time. The new material then becomes the focus of the next set of dual attention. In the session these sequences of dual attention and personal association are repeated many times. This process only works for patients who have experienced trauma.

(Source: http://www.emedicinehealth.com/nonepileptic_seizures_nes-health/article_em.htm)

NEW REGULATIONS: PNES is just as prevalent as conditions like multiple sclerosis, or trigeminal neuralgia. Unfortunately, misdiagnosis of PNES if common. Approximately 25% of patients who have a previous diagnosis of epilepsy and are not responding to drug therapy are found to be misdiagnosed. This is because physicians are taught to diagnose physical disorders as the cause of physical symptoms. Additionally the diagnosis of seizures depends on trained experts who are able to detect differences between a non-epileptic and an epileptic seizure. Last of all, many physicians do not have access to an EEG-video monitoring, which has to be performed by an epileptologist (a neurologist that specializes in epilepsy). This is the most reliable test to diagnose this condition. Having PNES comes with stigma because of the fact that it is caused by mental issues. Some might be labeled as crazy, or insane. However, those that suffer from PNES are not insane, but are recovering from the trauma in their lives.

(Source: http://www.epilepsy.com/article/2014/3/truth-about-psychogenic-nonepileptic-seizures)

* For More Information, Contact:

Daniel L. Drane, Ph.D.                                                Robin Reese

Emory University School of Medicine                      Associate Director, Media Relations

ddrane@emory.edu                                                    robin.j.reese@emory.edu