Diagnosis and Management of Psychogenic Nonepileptic Seizures (PNES)
Stacy Cruess, PhD (Psychologist, Institute of Living and Hartford Hospital Comprehensive Epilepsy Center)
Gabriel Martz, MD (Medical Director, Hartford Hospital Comprehensive Epilepsy Center)
April 2, 2019
Jefferson Building, Room 118
(Free parking is available at nearby Hartford Hospital Hudson St Garage)
Workshop is Free for all
CPA Members receive FREE CE
Non-CPA Members - $25 for CE
Psychogenic nonepileptic seizures (PNES) are paroxysmal changes in responsiveness, movement, or behavior that superficially resemble epileptic seizures but are not caused by epileptic neuronal discharges in the brain. Etiology is multifaceted and includes interaction of predisposing, precipitating, and perpetuating factors, of which psychological factors are hypothesized to play a significant role. Research has also suggested the potential role of altered structural and functional brain connectivity. PNES can be debilitating and stigmatizing – individuals with PNES often have the same or greater healthcare and disability costs as patients with similar, well-defined medical problems. Unfortunately, it typically takes years for people with PNES to get an accurate diagnosis and many individuals go for an extended period of time without appropriate treatment. Furthermore, as individuals with PNES typically present to Neurology specialists rather than to mental health professionals, many community-based mental health treatment providers have little to no experience in treating PNES and other Conversion Disorders. Treating neurologists often struggle with identifying clear pathways to access mental health care where their patients with PNES can receive appropriate treatment from providers who are experienced with the disorder. The purpose of this seminar is to educate mental health providers on what psychogenic nonepileptic seizures are, how they are diagnosed, common biopsychosocial correlates of PNES, and current knowledge of best practices for treating this disorder.
Presentations will be given by Dr. Gabriel Martz, an epileptologist and Medical Director of the Hartford Hospital Comprehensive Epilepsy Center, and by Dr. Stacy Cruess, a clinical health psychologist in the Comprehensive Epilepsy Center who provides evaluation and treatment of PNES patients. Through educating other mental health professionals about PNES and its treatment, Drs. Martz and Cruess also hope to begin to generate a network of providers in Connecticut to improve access to effective treatment for individuals diagnosed with PNES. Furthermore, Drs. Martz and Cruess hope to begin to establish relationships with interested mental health providers to facilitate ongoing collaborations for effective treatment and improved communication across disciplines to promote integrated care for people with PNES. In addition to didactic presentations, there will be opportunities for questions and discussion, with the goal of facilitating an interactive and dynamic dialogue.
Participants will be able to :
1. Describe the gold standard process for the diagnosis of psychogenic nonepileptic seizures.
2. Identify psychological, social, and neurobiological factors that are associated with psychogenic nonepileptic seizures.
3. Identify the 4 stages of treatment for psychogenic nonepileptic seizures and empirically supported treatment options for acute management of symptoms.