title: The approach to patients with psychogenic nonepileptic seizures in epilepsy surgery centers regarding diagnosis, treatment, and education.
abstract: Previous studies, using surveys, provided an understanding about how health-care providers address patients with PNES. To date, there is limited information on the management of patients with PNES by tertiary referral centers for epilepsy. In this study, we surveyed 11 Brazilian epilepsy center directors about diagnosis, treatment, education and research on PNES. Respondents reported that patients with PNES represented 10-20% of all adult patients recorded by video-EEG (VEEG). All respondents recognized VEEG as the method to confirm the diagnosis, and 81.8% used this approach for confirmation. Most centers had a standard protocol for diagnosis. None of the centers had a particular protocol to treat PNES, but 90.9% had a uniform treatment approach including therapy and educational measures. Psychotherapy was not easily obtained in nine centers (81.8%). Seven (63.3%) centers reported ongoing research projects with PNES. Five centers referred to an educational PNES program discussing diagnosis, but only one reported an educational program for treatment. This study showed a commitment to PNES diagnosis; however, some gaps remain regarding treatment and training, namely implementing a psychotherapy approach for patients and providing educational curricula for clinicians.
authors.affiliation: Department of Psychiatry, Clinics Hospital of the Faculty of Medicine, University of São Paulo (USP), São Paulo, SP, Brazil. Electronic address: kette.valente@hc.fm.usp.br.
authors.forename: Kette D
authors.initials: KD
authors.lastname: Valente
authors.affiliation: Department of Neurology, Clinics Hospital, Federal University of Paraná, Curitiba, PR, Brazil; Comprehensive Epilepsy Center, Hospital N S das Graças, Curitiba, PR, Brazil.
authors.forename: Luciano
authors.initials: L
authors.lastname: De Paola
authors.affiliation: Medicine and Health Sciences Post-Graduate Program, São Lucas Hospital, Catholic University (PUCRS) RS, Brazil; Department of Neurology, São Lucas Hospital, Catholic University (PUCRS) RS, Brazil; Epilepsy Surgery Program Service, São Lucas Hospital, Catholic University (PUCRS) RS, Brazil.
authors.forename: Andre
authors.initials: A
authors.lastname: Palmini
authors.affiliation: Brain Institute - Paulo Niemeyer, Rio de Janeiro, RJ, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Faveret
authors.affiliation: Department of Psychiatry and Medical Psychology, Faculty of Medicine of São José do Rio Preto, SP, Brazil.
authors.forename: Gerardo Maria
authors.initials: GM
authors.lastname: de Araujo-Filho
authors.affiliation: Neurologic Institute, Goiania, GO, Brazil.
authors.forename: Helio
authors.initials: H
authors.lastname: van der Linden
authors.affiliation: Basic Research and Advanced Investigations in Neurology, Clinic Hospital of Porto Alegre, Federal University of Rio Grande do Sul, RS, Brazil.
authors.forename: Marino M
authors.initials: MM
authors.lastname: Bianchin
authors.affiliation: Applied Neuroscience Center and Epilepsy Center of Santa Catarina (CEPESC), Hospital Universitário, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
authors.forename: Roger
authors.initials: R
authors.lastname: Walz
authors.affiliation: Department of Neurology, Medical School - ABC, Santo André, SP, Brazil.
authors.forename: Rudá
authors.initials: R
authors.lastname: Alessi
authors.affiliation: Department of Neurology, Clinics Hospital, Faculty of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Tonicarlo
authors.initials: T
authors.lastname: Velasco
authors.affiliation: Deparment of Neurology, Hospital de Base, Brasilia, Brazil.
authors.forename: Wagner A
authors.initials: WA
authors.lastname: Teixeira
authors.affiliation: Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, RI, USA; Department of Neurology, Rhode Island Hospital, Brown University, Providence, RI, USA.
authors.forename: W Curt
authors.initials: WC
authors.lastname: LaFrance
mesh_terms: D001938:Brazil; D004569:Electroencephalography / Q000379:methods; D019538:Health Care Surveys; D006801:Humans; D010353:Patient Education as Topic; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D011613:Psychotherapy; D012640:Seizures / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy
keywords: Diagnosis; Education; Nonepileptic seizures; PNES; Research; Treatment