Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.

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Psychogenic Non-Epileptic Events (PNEE) are paroxysmal episodes described as behavioral changes, sensory- sensitive disturbances, or motor manifestations that resemble epileptic seizures without showing underlying epileptiform activity, are not deliberately produced by the individual, and respond to...

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Detalles Bibliográficos
Autores: Quille Buendia, Adderly R, Herrera Aramburu, Manuel, Burneo, Jorge G
Formato: artículo
Fecha de Publicación:2020
Institución:Universidad Peruana Cayetano Heredia
Repositorio:Revistas - Universidad Peruana Cayetano Heredia
Lenguaje:español
OAI Identifier:oai:revistas.upch.edu.pe:article/3796
Enlace del recurso:https://revistas.upch.edu.pe/index.php/RNP/article/view/3796
Nivel de acceso:acceso abierto
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dc.title.none.fl_str_mv Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.
Eventos no epilépticos psicógenos: El desafío constante de su diagnóstico y tratamiento.
title Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.
spellingShingle Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.
Quille Buendia, Adderly R
title_short Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.
title_full Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.
title_fullStr Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.
title_full_unstemmed Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.
title_sort Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.
dc.creator.none.fl_str_mv Quille Buendia, Adderly R
Herrera Aramburu, Manuel
Burneo, Jorge G
author Quille Buendia, Adderly R
author_facet Quille Buendia, Adderly R
Herrera Aramburu, Manuel
Burneo, Jorge G
author_role author
author2 Herrera Aramburu, Manuel
Burneo, Jorge G
author2_role author
author
description Psychogenic Non-Epileptic Events (PNEE) are paroxysmal episodes described as behavioral changes, sensory- sensitive disturbances, or motor manifestations that resemble epileptic seizures without showing underlying epileptiform activity, are not deliberately produced by the individual, and respond to multifactorial biopsychosocial mechanisms. Epidemiological information is limited due to the heterogeneous nature of the affected population, and to the limited accessibility to the video electroencephalogram (vEEG) necessary for its diagnosis. In such context, the convergence of two important elements is necessary: a detailed clinical history (clinical characteristics suggestive of PNEE, and identification of the associated factors), and the absence of electroencephalographic “ictal” changes in the vEEG. A psychological evaluation provides additional information, relevant for the diagnostic corroboration and management. The diagnosis must be made in a timely manner, to avoid complications in its evolution and treatment. A positive and encouraging attitude to the patient is vital when informing him/her of the diagnosis, as it also is the coordination between the treating neurologist and mental health professionals involved in the management and monitoring of the case. Cognitive behavioral psychotherapy, associated with psychopharmacotherapy -when needed-- constitute the most effective treatment approach for these patients. There are limited studies on the current epidemiological and clinical evolution of patients with PNEE in Latin America, and additional research regarding this problem is much needed, given its impact on the quality of life of the patients and on the cost of its management in the health care systems.
publishDate 2020
dc.date.none.fl_str_mv 2020-10-09
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://revistas.upch.edu.pe/index.php/RNP/article/view/3796
10.20453/rnp.v83i3.3796
url https://revistas.upch.edu.pe/index.php/RNP/article/view/3796
identifier_str_mv 10.20453/rnp.v83i3.3796
dc.language.none.fl_str_mv spa
language spa
dc.relation.none.fl_str_mv https://revistas.upch.edu.pe/index.php/RNP/article/view/3796/4276
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eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidad Peruana Cayetano Heredia
publisher.none.fl_str_mv Universidad Peruana Cayetano Heredia
dc.source.none.fl_str_mv Revista de Neuro-Psiquiatria; Vol. 83 No. 3 (2020): July - September (pre-print); 165-176
Revista de Neuro-Psiquiatría; Vol. 83 Núm. 3 (2020): Julio-Setiembre; 165-176
Revista de Neuro-Psiquiatria; v. 83 n. 3 (2020): Julio-Setiembre; 165-176
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spelling Psychogenic non epileptic events: The constant challenge of its diagnosis and treatment.Eventos no epilépticos psicógenos: El desafío constante de su diagnóstico y tratamiento.Quille Buendia, Adderly RHerrera Aramburu, ManuelBurneo, Jorge GPsychogenic Non-Epileptic Events (PNEE) are paroxysmal episodes described as behavioral changes, sensory- sensitive disturbances, or motor manifestations that resemble epileptic seizures without showing underlying epileptiform activity, are not deliberately produced by the individual, and respond to multifactorial biopsychosocial mechanisms. Epidemiological information is limited due to the heterogeneous nature of the affected population, and to the limited accessibility to the video electroencephalogram (vEEG) necessary for its diagnosis. In such context, the convergence of two important elements is necessary: a detailed clinical history (clinical characteristics suggestive of PNEE, and identification of the associated factors), and the absence of electroencephalographic “ictal” changes in the vEEG. A psychological evaluation provides additional information, relevant for the diagnostic corroboration and management. The diagnosis must be made in a timely manner, to avoid complications in its evolution and treatment. A positive and encouraging attitude to the patient is vital when informing him/her of the diagnosis, as it also is the coordination between the treating neurologist and mental health professionals involved in the management and monitoring of the case. Cognitive behavioral psychotherapy, associated with psychopharmacotherapy -when needed-- constitute the most effective treatment approach for these patients. There are limited studies on the current epidemiological and clinical evolution of patients with PNEE in Latin America, and additional research regarding this problem is much needed, given its impact on the quality of life of the patients and on the cost of its management in the health care systems.Los eventos no epilépticos psicógenos (ENEP) son episodios paroxísticos descritos como cambios conductuales, alteraciones sensorio-sensitivas, o manifestaciones motoras que se asemejan a las crisis epilépticas pero sin mostrar actividad epileptiforme subyacente, no son producidos deliberadamente por el individuo, y responden a mecanismos multifactoriales de índole biopsicosocial. La información epidemiológica es limitada debido a la naturaleza heterogénea de la población afectada, así como a la escasa accesibilidad al videoelectroencefalograma (vEEG) necesario para su diagnóstico. En este contexto, es necesaria la convergencia de dos elementos importantes: historia clínica detallada (características clínicas sugerentes de ENEP e identificación de los factores asociados) y la ausencia de cambios electroencefalográficos en el vEEG durante el episodio. La evaluación psicológica provee información adicional relevante para la corroboración diagnóstica y para su manejo. El diagnóstico debe realizarse de manera oportuna, para evitar complicaciones en su evolución y tratamiento. Es vital una actitud positiva y alentadora hacia el/la paciente al momento de comunicarle su diagnóstico, así como la coordinación entre el neurólogo tratante y los profesionales de salud mental involucrados en el manejo y seguimiento del caso. La psicoterapia cognitiva conductual, asociada a psicofármacoterapia -cuando pertinente-, constituyen el tratamiento más eficaz de estos pacientes. Existen limitados estudios en Latinoamérica sobre aspectos epidemiológicos y clínico-evolutivos de pacientes con ENEP, por lo que más investigación y publicaciones respecto a esta problemática son indispensables dado su impacto sobre la calidad de vida de los pacientes y sobre el costo de su manejo en los sistemas de salud.Universidad Peruana Cayetano Heredia2020-10-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://revistas.upch.edu.pe/index.php/RNP/article/view/379610.20453/rnp.v83i3.3796Revista de Neuro-Psiquiatria; Vol. 83 No. 3 (2020): July - September (pre-print); 165-176Revista de Neuro-Psiquiatría; Vol. 83 Núm. 3 (2020): Julio-Setiembre; 165-176Revista de Neuro-Psiquiatria; v. 83 n. 3 (2020): Julio-Setiembre; 165-1761609-73940034-8597reponame:Revistas - Universidad Peruana Cayetano Herediainstname:Universidad Peruana Cayetano Herediainstacron:UPCHspahttps://revistas.upch.edu.pe/index.php/RNP/article/view/3796/4276info:eu-repo/semantics/openAccessoai:revistas.upch.edu.pe:article/37962020-10-10T04:43:49Z
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