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18 results

  • The role of neuropsychology in the care of patients with functional neurological symptom disorder

  • Ryan Van Patten, Kristen Mordecai, W. Curt LaFrance, Jr
  • Journal:
    Journal of the International Neuropsychological Society / Volume 30 / Issue 7 / August 2024
    Published online by Cambridge University Press:
    30 May 2024, pp. 710-717
    • Article
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      • Open access
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  • Objective:

    Functional neurological symptom disorder (FNSD) is a neuropsychiatric condition characterized by signs/symptoms associated with brain network dysfunction. FNSDs are common and are associated with high healthcare costs. FNSDs are relevant to neuropsychologists, as they frequently present with chronic neuropsychiatric symptoms, subjective cognitive concerns, and/or low neuropsychological test scores, with associated disability and reduced quality of life. However, neuropsychologists in some settings are not involved in care of patients with FNSDs. This review summarizes relevant FNSD literature with a focus on the role of neuropsychologists.

    Methods:

    A brief review of the literature is provided with respect to epidemiology, public health impact, symptomatology, pathophysiology, and treatment.

    Results:

    Two primary areas of focus for this review are the following: (1) increasing neuropsychologists’ training in FNSDs, and (2) increasing neuropsychologists’ role in assessment and treatment of FNSD patients.

    Conclusions:

    Patients with FNSD would benefit from increased involvement of neuropsychologists in their care.

Gates and Rowan's Nonepileptic Seizures
  • 4th edition
  • Edited by W. Curt LaFrance, Jr, Steven C. Schachter
  • Published online:
    18 May 2018
    Print publication:
    03 May 2018
  • Patients with nonepileptic seizures (NES) frequently present in neurology, psychiatry, psychology, and emergency departments. The disorder has been well-documented in the medical literature, and much is known about the phenomenology, ictal semiology, neurologic signs, psychiatric comorbidities, neuropsychological testing, and psychosocial aspects. Since the publication of the third edition in 2010, knowledge of treatments for NES has grown and new data have become available. Fully updated to reflect these developments, this fourth edition brings together the current knowledge of NES treatments, drawing on the experience of an international team of authors. An accompanying website features video-EEGs of seizures and videos of patient-clinician interactions, which will help readers with both diagnostic and management decisions. Tables clearly illustrating the differential diagnosis of various nonepileptic events give readers quick reference guides to aid diagnostic assessment. A valuable resource for neurologists, psychiatrists, psychologists, and any clinicians who encounter NES in their practice.

  • Nonepileptic seizures: an updated review

  • David L. Perez, W. Curt LaFrance, Jr.
  • Journal:
    CNS Spectrums / Volume 21 / Issue 3 / June 2016
    Published online by Cambridge University Press:
    21 March 2016, pp. 239-246

  • Psychogenic nonepileptic seizures (PNES) are a functional neurological disorder/conversion disorder subtype, which are neurobehavioral conditions at the interface of neurology and psychiatry. Significant advancements over the past decade have been made in the diagnosis, management, and neurobiological understanding of PNES. This article reviews published PNES research focusing on semiologic features that distinguish PNES from epileptic seizures, consensus diagnostic criteria, the intersection of PNES and other comorbidities, neurobiological studies, evidence-based treatment interventions, and outcome studies. Epidemiology and healthcare utilization studies highlight a continued unmet medical need in the comprehensive care of PNES. Consensus guidelines for diagnostic certainty are based on clinical history, semiology of witnessed typical event(s), and EEG findings. While certain semiologic features may aid in the diagnosis of PNES, the gold standard remains capturing a typical event on video electroencephalography (EEG) showing the absence of epileptiform activity with history and semiology consistent with PNES. Medical-neurologic and psychiatric comorbidities are prevalent in PNES; these should be assessed in diagnostic evaluations and integrated into treatment interventions and prognostic considerations. Several studies, including a pilot, multicenter, randomized clinical trial, have now demonstrated that a cognitive behavioral therapy–informed psychotherapy is an efficacious treatment for PNES, and additional efforts are necessary to evaluate the utility of pharmacologic and other psychotherapy treatments. Neuroimaging studies, while requiring replication, suggest that PNES may occur in the context of alterations within and across sensorimotor, emotion regulation/processing, cognitive control, and multimodal integration brain systems. Future research could investigate similarities and differences between PNES and other somatic symptom disorders.