Treatment and outcome of psychogenic nonepileptic seizures

Psychogenic nonepileptic seizures (PNES) are episodes that resemble epileptic seizures but are due purely to the emotions. Their clinical features vary considerably and it often is difficult to distinguish PNES from epileptic seizures without video-EEG monitoring. They can be due to a variety of underlying emotional difficulties, though some patients are found to be emotionally normal. Treatment varies, and depends upon the underlying etiology. Response to treatment also varies, and a substantial subset of patients continue to have episodes. We need to improve our abilities to determine etiologies underlying PNES in individual patients, in our abilities to treat these etiologies, and in the supply of personnel able to do this.