Psychogenic Non-epileptic Seizures: An Updated Primer

Background: Psychogenic non-epileptic seizures are the most common paroxysmal event misdiagnosed as epilepsy. They signcantly affect quality of life, functional status, and use of medical resources. Objective: The goal of this review is to provide guidance to psychiatrists and other mental health professionals in the understanding and practical management of this condition. Results: An abundance of new reports on the pathogenesis and effective treatments have become available over the last decade, yet specific barriers impede the fluid transition to treatment and remain an important challenge in the management of patients with psychogenic non-epileptic seizures. In the context of these difficulties, we initially present background information on psychogenic non-epileptic seizures covering their historic context, epidemiology, etiologic factors (including psychiatric, neuromedical, and neuropsychological factors), and current neurobiological models. Updated evidence-based treatments are discussed along with data on long-term outcomes. We also provide practical tools to help clinicians navigate differential diagnoses, establish their interdisciplinary roles, communicate the diagnosis, deliver treatment, and sort out commonly encountered challenges in the management of this condition.