PubMed · 8675124
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I Amir, M Neufeld. 1996-02-15. [Conversion nonepileptic seizures].. https://pubmed.ncbi.nlm.nih.gov/8675124/
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Hysteria/conversion disorder has been described since antiquity. One French neurologist dubbed it "neurological nonsense" because its presentation was so complex and confusing. For nosological purposes for inclusion into the Diagnostic Statistical Manual, multiple revisions of conversion disorder terminology were made for each edition published from 1952-1994. Until recently, conversion disorder was thought to be solely psychological in origin: new studies raise the possibility that what is called conversion disorder is actually early disruption in the functioning of the nervous system in predisposed individuals. Because of its uncanny resemblance to neurological disease, the differential diagnosis is critical and should be exhaustive in its efforts to rule out neurological disease. The neuroscience nurse needs to be aware of this perplexing syndrome called conversion disorder and the never theories that suggest organic causation and interventions to enhance recovery.
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Psychogenic nonepileptic seizures (NES) are commonly encountered in clinical practice, and they may pose difficult diagnostic problems. For appropriate evaluation and treatment of NES, a multidisciplinary team approach is needed; typically, a neurologist with expertise in epilepsy, a psychologist or psychiatrist, and a support staff should be involved. Psychogenic NES have no single initial clinical manifestation, and various etiologic factors may contribute to their development. Of importance, psychogenic NES are "real" seizures that may be as disabling as epileptic seizures. Most often, they occur on a subconscious level, and the patient may have no control over their occurrence. Precipitation or termination of a habitual seizure during video-electroencephalographic monitoring has often been used to distinguish NES from epileptic seizures, but the results can sometimes be misleading. Numerous additional diagnostic techniques can be used to assist in making the diagnosis. Treatment is based on the type of psychiatric disorder present. Favorable prognostic factors include being female and having an independent lifestyle, normal electroencephalographic findings, higher intelligence, and no prior psychotherapy.