Editing Talk:Psychogenic non-epileptic seizure (section)

== Removal of bad information in signs and symptoms, treatment, and prognosis ==

Removed the following claim in "signs and symptoms:"

: PNES episodes are nearly indistinguishable from epileptic seizures. The main differences between a PNES episode and an epileptic seizure is the duration of episodes. Epileptic seizures typically last between 30 and 120 seconds depending on the type, while PNES episodes typically last for two to five minutes.

which was contradicted by the following in "diagnosis:"

: Some features are more or less likely to suggest PNES but they are not conclusive and should be considered in the broader clinical picture. Features that are common in PNES but rarer in epilepsy include: biting the tip of the tongue, seizures lasting more than two minutes (easiest factor to distinguish), seizures having a gradual onset, a fluctuating course of disease severity, the eyes being closed during a seizure, and side to side head movements. Features that are uncommon in PNES include automatisms (automatic complex movements during the seizure), severe tongue biting, biting the inside of the mouth, and incontinence.
: If a person with suspected PNES has an episode during a clinical examination, there are a number of signs that can be elicited to help support or refute the diagnosis of PNES. Compared to people with epilepsy, people with PNES will tend to resist having their eyes forced open (if they are closed during the seizure), will stop their hands from hitting their own face if the hand is dropped over the head, and will fixate their eyes in a way suggesting an absence of neurological interference.

Moved all of this info from diagnosis into signs and symptoms, and added more details and sources.

Removed the following from "treatment," overly detailed and not sourced at all.

: Eight points recommended to explain the diagnosis to the person and their caregivers are:
:* Reasons for concluding they do not have epilepsy
:* What they do have (describe functional neurological disorder)
:* Emphasize they are not suspected of "putting on" the attacks, and the symptoms are not "all in their head"
:* There may be no triggering "stresses"
:* Maintaining factors
:* May improve after correct diagnosis
:* Caution that anticonvulsant drug withdrawal should be done in conjunction with their physician
:* Describe treatment to help regain control of symptoms

Removed the following paragraph from "prognosis." The first sentence is directly contradicted by its own source; the others are all sourced from studies from the 90s. Treatment for PNES has greatly improved over the last 30 years, and studies from the 90s of untreated PNES patients aren't good sources for modern PNES prognosis. 

: Functional seizures have been found to be as disabling and costly as epilepsy. Though there is limited evidence, outcomes appear to be relatively poor with a review of outcome studies finding that two-thirds of people with PNES continue to experience episodes and more than half are dependent on the Social Security program at three-year follow-up. This outcome data was obtained in a referral-based academic epilepsy center and loss to follow-up was considerable; the authors point out ways in which this may have biased their outcome data. Outcome was shown to be better in people with higher IQ, social status, greater educational attainments, younger age of onset and diagnosis, attacks with less dramatic features, and fewer additional somatoform complaints.
[[Special:Contributions/137.22.90.64|137.22.90.64]] ([[User talk:137.22.90.64|talk]]) 08:01, 27 May 2024 (UTC)