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Myths and truths about pediatric psychogenic nonepileptic seizuresopen access

Authors
Yeom, J.S.Bernard, H.Koh, S.
Issue Date
2021
Publisher
Korean Pediatric Society
Keywords
Dissociative reaction; Emotional stress; Neurobiology; Nonepileptic seizure; Somatic symptoms
Citation
Clinical and Experimental Pediatrics, v.64, no.6, pp.251 - 259
Indexed
SCOPUS
KCI
Journal Title
Clinical and Experimental Pediatrics
Volume
64
Number
6
Start Page
251
End Page
259
URI
https://scholarworks.bwise.kr/gnu/handle/sw.gnu/5515
DOI
10.3345/cep.2020.00892
Abstract
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 mindbody 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 PNESmay 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 systemdysfunction, 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. ? 2021 by The Korean Pediatric Society.
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의과대학 (의학과)
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