Treatment
There has been one randomized controlled trial that examined treatment with antidepressive medication in PNES. The study investigated 38 patients and found that those who were treated with Zoloft, got better effect than those treated with placebo.
An important first step is a discussion with the patient that explains their diagnosis in a sensitive and open manner. A negative diagnosis experience will frustrate the patient and could cause them to reject any further attempts at treatment. Ten points to breaking the diagnosis to the person and their carers are:
- Reasons for concluding they do not have epilepsy
- What they do have (describe dissociation)
- Emphasise they are not suspected of "putting on" the attacks
- They are not "mad"
- Triggering "stresses" may not be immediately apparent.
- Relevance of aetiological factors in their case
- Maintaining factors
- May improve after correct diagnosis
- Caution that anticonvulsant drug withdrawal should be gradual
- Describe psychological treatment
Psychotherapy is the most frequently used treatment, which might include cognitive behavioral therapy, insight-orientated therapy, and/or group work. Where there is a co-morbid psychiatric condition, treatment with antidepressant medication can be helpful.
Read more about this topic: Hystero-epilepsy
Famous quotes containing the word treatment:
“James’s great gift, of course, was his ability to tell a plot in shimmering detail with such delicacy of treatment and such fine aloofness—that is, reluctance to engage in any direct grappling with what, in the play or story, had actually “taken place”Mthat his listeners often did not, in the end, know what had, to put it in another way, “gone on.””
—James Thurber (1894–1961)
“The treatment of the incident of the assault upon the sailors of the Baltimore is so conciliatory and friendly that I am of the opinion that there is a good prospect that the differences growing out of that serious affair can now be adjusted upon terms satisfactory to this Government by the usual methods and without special powers from Congress.”
—Benjamin Harrison (1833–1901)
“I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrongdoing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly, I will not give to a woman a pessary to cause abortion. I will keep pure and holy both my life and my art.”
—Hippocrates (c. 460–c. 370 B.C.)