Non-epileptic psychogenic seizures

Introduction. Non-epileptic psychogenic seizures (NEPS) is a pathological condition that arouses the interest of many specialists due to the fact that, everyday, it gives rise to problems in different fields-especially in diagnosis and therapeutics. This means that sometimes the right diagnosis is reached after a period of explorations and treatment which later turn out to be unnecessary, and have important repercussions on the patient's family and social life, and, financially, on the health care system. Method We review the literature on the subject that has been published over the last five years, with the aim of contrasting and integrating the different positions that are currently held. We draw attention to the better known aspects, on which there is a more general agreement, and others that are still subject to controversy and debate; we also attempt to lay down a set of guidelines, bearing in mind the gaps that are still to be filled, to aid future research. Conclusions. 1. NEPS is very difficult to diagnose. It is important to have a good clinical history to be able to identify possible stressors. Video-EEG can be of great help, although it is very expensive and not available to all Neurology services. 2. Before deciding on the final diagnosis, frontal, frontomesial and temporal lobe seizures must be taken into account since they sometimes present symptoms that are similar to those of NEPS. 3. The association with different psychiatric pathologies has been shown to exist, and more than one psychopathogenic mechanism may be involved as a mediator in the appearance of NEPS 4. Therapy begins with the presentation of the diagnosis, which must be performed with due care and attention, and is aided by a multidisciplinary treatment.