title: Psychogenic nonepileptic seizures.
abstract: OBJECTIVE
  This review summarizes the recent studies assessing patients with psychogenic nonepileptic seizures and developments in treatment.
  
  
  RESULTS
  The misdiagnosis of nonepileptic seizure is costly to patients, the healthcare system, and to society. Patients with nonepileptic seizures are prescribed antiepileptic drugs that do not treat nonepileptic seizures, have multiple laboratory tests performed, and may not receive the necessary mental healthcare that could benefit them.The first step in nonepileptic seizure treatment is proper diagnosis. Video electroencephalography remains the gold standard for nonepileptic seizure diagnosis. Certain seizure types, such as frontal lobe seizures, may mimic nonepileptic seizure semiology. Bedside observations may augment video electroencephalography to establish nonepileptic seizure diagnosis. The methodology in nonepileptic seizure treatment trials is examined, describing the challenges in conducting clinical trials with patients with overlapping neurologic and psychiatric disorders. Finally, realizing that nonepileptic seizures are in a spectrum of somatoform disorders, diagnostic literature is reviewed in other conversion disorders.
  
  
  CONCLUSIONS
  Nonepileptic seizure patients remain one of the most challenging populations to diagnose and treat in medical practice. Clinical findings and laboratory advances exist that more clearly establish the diagnosis of nonepileptic seizures. With the appropriate diagnosis, neurologists and mental health providers are better equipped to treat the underlying causes of nonepileptic seizures.
authors.affiliation: Rhode Island Hospital, Providence, Rhode Island, USA. William_LaFrance_Jr@Brown.edu
authors.forename: W Curt
authors.initials: WC
authors.lastname: LaFrance
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D015984:Causality; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control; D004569:Electroencephalography / Q000592:standards; D006801:Humans; D001523:Mental Disorders / Q000150:complications* / Q000503:physiopathology; D012640:Seizures / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000503:physiopathology; D014741:Video Recording / Q000592:standards
chemical_list: D000927:Anticonvulsants