Neuro: Psychogenic Non-Epileptic Seizures: Free MSRA Podcast

🎧 FREE MSRA PODCAST – Psychogenic Non-Epileptic Seizures (PNES): Mastering the MimicryStruggling to distinguish between epileptic and non-epileptic seizures? This Deep Dive covers PNES, a high-yield exam topic and an essential real-life diagnostic challenge. We’ll walk through classic clues, key differentiators, and the must-know management for the MSRA.📝 Key Learning Points📌 Definition• PNES are episodes that look like epileptic seizures but are NOT caused by abnormal electrical activity in the brain.• They are functional neurological symptoms, often arising from psychological distress (a form of conversion disorder).• Also called Non-Epileptic Attack Disorder (NEAD).📌 Core Features• Shaking, unresponsiveness, convulsions—just like epilepsy• But: No EEG changes during the event📌 Key Differentiators (from Epilepsy)• Gradual onset, longer duration, waxing/waning intensity• Pelvic thrusting, side-to-side head movement, eyes tightly shut• Recollection of events during apparent unresponsiveness• Often triggered by stress, rarely occurs when alone• Crying post-event, absence of post-ictal confusion• Classic epilepsy signs: Side tongue-biting, automatisms, and raised serum prolactin point to epilepsy, but not 100% reliable📌 Causes & Risk Factors• Psychological trauma (e.g. abuse, PTSD)• High stress, emotional conflict• Coexisting psychiatric disorders: anxiety, depression, personality disorders• Female predominance, often in young adults• History of epilepsy or family members with epilepsy• NB: PNES is involuntary—never consciously faked📌 Differential Diagnosis• Epilepsy (generalised/focal)• Syncope, cardiac arrhythmia, hypoglycaemia, migraine, TIA• Panic attacks, dissociative disorders, factitious disorder, movement disorders, sleep disorders📌 Epidemiology• 15–20% of referrals to epilepsy clinics; up to 40% in epilepsy monitoring units• More common in women, but can affect all ages and backgrounds📌 Diagnosis• Gold standard: Video EEG monitoring (seizure-like activity with no EEG change)• Multidisciplinary assessment: Detailed clinical history, psychiatric evaluation• Rule out metabolic, cardiac, neurological causes• Serum prolactin NOT reliable for diagnosis📌 Management• Psychological therapy is KEY – especially cognitive behavioural therapy (CBT)• Antiepileptic drugs are not effective and may be harmful• Treat underlying psychiatric conditions (anxiety, depression, PTSD)• Multidisciplinary care: neurologist + psychiatry/psychology• Patient & family education/support• Early referral to psychological services is essential for best outcomes📌 Prognosis & Complications• Prognosis improves with early recognition, diagnosis, and engagement with therapy• Untreated: persistent disability, reduced quality of life, continued distress, unnecessary drug side effects• Delayed/missed diagnosis = years of ineffective treatment• Comorbid psychiatric issues can complicate recovery📎 More MSRA PNES Resources:📝 Revision Notes: https://www.passthemsra.com/topic/psychogenic-non-epileptic-seizures-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/psychogenic-non-epileptic-seizures-flashcards/💬 Accordion Q&A: https://www.passthemsra.com/topic/psychogenic-non-epileptic-seizures-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/psychogenic-non-epileptic-seizures-rapid-quiz/🧪 Quiz Bank: https://www.passthemsra.com/quizzes/psychogenic-non-epileptic-seizures/🎓 Neurology MSRA Course: https://www.passthemsra.com/courses/neurology-for-the-msra/#MSRA #PNES #PsychogenicNonEpilepticSeizures #MSRARevision #MSRAFlashcards #MSRAQuiz #MSRAAccordions #Neurology #EpilepsyMimics #ConversionDisorder #PassTheMSRA