Talk:Psychogenic non-epileptic seizure

message: I removed the assertion that psychogenic seizures are not psychogenic.  This article is about psychogenic seizures.  Other sorts of seizures, non-psychogenic in origin, are detailed in articles listed under 'see also'.  Repeatedly explaining, in an article called "psychogenic seizures," that psychogenic seizures are not psychogenic is confusing and ultimately pointless.  This would be similar to repeated assertions in the article entitled Dog, that dogs are not in fact dogs but are cats.
If someone wants to create a section entitled "Controversy," with text along the lines of "Some authorities have stated that psychogenic seizures do not exist per se," that might be a good idea.  It would need, however, to be cited, as with any other contribution to Wikipedia, because Wikipedia forbids original research.  I am eager, of course, to learn of the existence of any such verifiable statements, and strongly suggest that if they exist they be placed into the article.
-ikkyu2 (talk) 23:13, 12 April 2006 (UTC)
thread_title: Psychogenic seizures not psychogenic?

message: Photosensitive epilepsy are of an epilepic origin ,and shouldt be a part of this article
The Procrastinator 21:57, 29 December 2005 (UTC)
thread_title:  Flashlight seizures 

message: The article discusses a syndrome of recurrent seizures which has no better singular name.  An isolated psychogenic seizure does not qualify as conversion disorder, does not require treatment, and in general is different than the syndrome which is discussed in the article.   Refer to  for more. -Ikkyu2 23:42, 20 January 2006 (UTC)
thread_title:  Why is 'seizures' plural in the article name? 

message: A recent edit included the following text, which I've reverted.  Discussion follows:
In the past the patient with psychogenic non-epileptic seizures was thought to have a history of childhood physical abuse or sexual abuse or other severe emotional trauma. Treatment, with cognitive therapy or behavioral therapy, would be focused on strategies to recognize the onset of the seizures and use techniques to abort them, or to interrupt the stimulus-response pathway that produces them.
This is now largely discredited with only a few Psychiatrists willing to pursue this line. These tend to be non-organic such as the leading exponent Douglas Turkington who has led research into the abuse causes of seizures. Turkington holds that even though the patient and their family may not remember the abuse this is because the abuse is repressed (see Freud and the unconscious). As no empirical proof can be provided for this theory other specialists regard such theories as pseudo-science.
This is even more true given the fact that most epilepsy specialists recognise that a) some seizures, especially complex frontal lobe, are very hard to diagnose b) respone to medication is no indication of the pseudo nature of the seizure as patients diagnosed with epilepsy frequently do not respond to treatment.
* "In the past, the patient with PNES was thought to have a history of childhood physical or sexual abuse."  That's not what this paragraph, which I wrote, originally said.  It said that such patients were often found to give such a history.  That's still true, and I've reverted it to say "sometimes found to give such a history."  Mangling text - sourced text, no less - to distort its meaning and then rebutting it is poor editing form, and I request that you not do so in the future.
* According to Betts, 1997, in EPILEPSY: A COMPREHENSIVE TEXTBOOK, (see article for reference) cognitive behavioral therapy is still the mainstay of treatment technique.  If you are going to cite a different theory, such as Mr Turkington's, please provide a verifiable reference published by a reputable source.
* The paragraph about frontal lobe seizures is not relevant to an article section about the treatment of non-epileptic seizures.  Non-epileptic seizures are not caused by epilepsy.  If you wish to assert, in an article called 'Psychogenic non-epileptic seizures,' that non-epileptic seizures are caused by epilepsy, I suggest creating a section called 'Criticism' or 'Controversy' and placing your assertions there.  If the assertions are not verifiably referenced, they will be removed.
ikkyu2 (talk) 19:43, 16 February 2006 (UTC)
replies: text: Also, honestly, I can't understand how editors to this page can use the term pseudoseizures, right after the introduction to the article asserts that that term should never be used.  I encourage people thinking of editing the article to read it first.  If you're going to write paragraphs about pseudoseizures, at least delete the part where the article admonishes readers never to use the term. ikkyu2 (talk) 03:37, 17 February 2006 (UTC)
thread_title:  Revert to recent edit. 

message: I've created Non-epileptic attack disorder (NEAD) as a redirect to this excellent article. It appears that there is a US/UK split on terminology here, possibly resulting from the influence of Dr Tim Betts (former editor of the journal Seizure and advisor to Epilepsy Action). The two big UK charities have articles referring to NEAD rather than PNES (Epilepsy Action, The National Society for Epilepsy). Searches for NEAD on PubMed tend to show UK research.
I wonder if it we should mention "Non-epileptic Attack Disorder (NEAD)" in the article - otherwise folk may wonder if it is a different thing. I do think there is a subtle difference between NEAD and PNES. NEAD, in using the term "Disorder" appears to be more like a diagnosis/disease. Whereas PNES is a label for symptoms or the manifestation of a disease. (Apologies if I'm not using the precise medical terms here).
Ikkyu2 - The NSE online article mentioned above is written by Tim Betts, who is also the author of one of your references. I can't read the book. However, reading the online article I suspect the article and the chapter have much in common. If you agree, I suggest this article be added to either the External Links or perhaps in the References as an option for those unable to consult the book.
:I agree without any reservation. -ikkyu2 (talk) 21:22, 1 March 2006 (UTC)
thread_title: Non-epileptic Attack Disorder

message: Whilst I agree the term pseudoseizures is unsatisfactory, we have perhaps yet to find the ideal term. See  for a study from the patient's point of view. The following statistics are also interesting:
* non-epileptic attack disorder  - 19 PubMed Articles, 281 Google results
* psychogenic non-epileptic seizures - 25 PubMed Articles, 477 Google results
* non-epileptic seizures - 92 PubMed Articles, 16,300 Google results, this recent book on Amazon: 
* pseudoseizures - 233 PubMed Articles, 25,100 Google results, this recent book on Amazon: 
The term pseudoseizures still appears in recent articles and books - it is not going away quickly --Colin 17:58, 17 February 2006 (UTC)
replies: text: This isn't just my own personal POV, by the way; although it happens to be, it is also clearly explained, in exactly the way it's explained here in the linked article from the Epilepsy Foundation on PNES.  -ikkyu2 (talk) 02:00, 3 March 2006 (UTC)
thread_title: Pseudoseizures

message: In the paragraph "Causes", there is the sentence "A history of abuse or other psychological trauma is often present as a causative factor", and then a request for citation needed. I would propose the following article as a well done study in reputable medical journal: Nonepileptic seizures and childhood sexual and physical abuse. Kenneth Alper, Orrin Devinsky, Kenneth Perrine, Blanca Vazquez, Daniel Luciano. Neurology, 1993, 43(10). Pubmed ID: 8413951   https://doi.org/10.1212/WNL.43.10.1950  — Preceding unsigned comment added by 70.20.25.26 (talk) 13:22, 30 September 2018 (UTC)
replies: text: This isn't the relevent article to answer your question. Have a look at Epilepsy:Causes, though that doesn't really cover one-off seizures. Seizures can be provoked by taking certain drugs and alcohol (and also during withdrawal). Colin°Talk 10:08, 25 March 2006 (UTC)
thread_title:  what can cause them? 

message: I removed the following text from the article:
: Treatment based on insight-oriented techniques or exploring of abuse histories has not been found to be effective.... Instead, treatment with cognitive therapy or behavioral therapy is focused on concrete strategies to recognize the triggers of the seizures and use techniques to control them and eventually halt the onset.
Those statements are not supported by the references provided. None of the references provided even mentions non-epileptic seizures or their treatment.
There appears to be very little evidence regarding effective treatment for this condition. I did find one study, here, which supports CBT. But I'm not sure that one study warrants inclusion in the encyclopedia.Twerges (talk) 08:12, 9 March 2009 (UTC)
thread_title:  Removed unsupported assertion 

message: There was some question about my edit here. Another editor claimed on my user page that:
: [The edit] removed information that was referenced properly.
The claims were not referenced properly. The claims are followed by references which do not support the claims at all.
For example, take the reference from the mayo clinic website. It says this about treatment:
: Seeing a psychologist or professional counselor can help treat symptoms of conversion disorder and prevent it from coming back. This can be especially helpful if you have anxiety, a mood disorder such as depression or other mental health issues.
That does not support the superiority of CBT over insight therapy for this condition. In fact, it does not even mention either CBT or insight therapy.
The other references are even less related to the claims. Most of the references either do not mention CBT or do not mention PNES. One of the references is a general criticism of psychotherapy research and has nothing to do with this topic. Another reference has a malformed URL and goes nowhere.
The only reference which has any support at all for the claims made was here. However, that reference only includes support in the "user comments" section at the bottom of the article, in which anonymous users wrote comments like "CBT worked for me" and so on. That is not an acceptable reference for the claims made, since user comments are not reliable according to WP:RS.
When I did a quick search of pubmed, I found little support for the claims which I deleted. I found exactly one study which supported CBT for this condition: . That study does not compare the effectiveness of CBT versus insight therapy for this condition.
Twerges (talk) 19:28, 5 April 2009 (UTC)
replies: text: Thank you for the clarification. I confess I did not go to the original soruces to verify that they stated what they were being used to support. My oversight, sorry and thanks. --PaulWicks (talk) 19:38, 5 April 2009 (UTC)
thread_title:  Removal of unsupported claims in Treatment section 

message: I am attempting to upgrade this article from a slightly woolly hodgepodge of polemics to a decent article. I'm currently integrating a lot of content from Dr Mellor's recent review and will go out and find some more recent references to weave in once I'm done. All assistance gratefully received! Cheers, --PaulWicks (talk) 20:24, 5 April 2009 (UTC)
thread_title: Overhauling the article

message: The article Hystero-epilepsy is somewhat unclear, but looks to me to be suggesting that an anecdote about Charcot is worth an entire encyclopedia article. I disagree and suggest we mention "Hystero-epilepsy" as an outdated term for PNES in the article here and delete the Hystero-epilepsy article. Whaddya reckon? --PaulWicks (talk) 21:21, 5 April 2009 (UTC)
replies: text: Yes, I concur.  That article is a stub, and has been for quite a while.  It's unlikely it will ever be developed further. Merging is a good plan.  --Jack-A-Roe (talk) 21:33, 5 April 2009 (UTC)
replies: text: Only if you can find a reliable source that says Hystero-epilepsy was actually a form of psychogenic non-epileptic seizures. It looks that way, and a peculiar one at that -- where the patients presented having nothing resembling epilepsy but were placed in a ward with "similar" patients who displayed "epileptic" attacks and they then hysterically "caught" epilepsy from them.  If you do merge, it needs to have its own section and made quite clear that this was an invented disease and a product of the hospital care these women received. PNES is not an invented disease. Colin°Talk 22:04, 5 April 2009 (UTC)
replies: text: Colin, I think those are fair suggestions and align with what I had in mind. I will await a few more comments before taking action (or not), maybe later this week. --PaulWicks (talk) 07:51, 6 April 2009 (UTC)

text: Hi there, I'd say it can probably be trimmed but retained. I will take a scalpel to it and see what we think. --PaulWicks (talk) 08:53, 21 June 2012 (UTC)
replies: text: Looks much better to me. Thanks for the edit. 50.135.73.142 (talk) 05:34, 23 June 2012 (UTC)
thread_title: Merger proposal

message: I query whether the author may have gotten his or her wires crossed in the "Distinguishing Features" section. The diagnostic criteria for NEAD are stated earlier in the article as including an absence of malingering - why, then, does the author use the work 'faking' in the final line of this section?
"Mellors et al. warn that such tests are neither conclusive nor impossible for a determined patient with factitious disorder to "pass" through faking convincingly."  — Preceding unsigned comment added by 138.253.244.181 (talk) 09:16, 27 September 2011 (UTC)
thread_title:  Factitious Seizures? 

message: Hi all,
This page is looking quite good, but I did notice some rather bold claims e.g. PNES are caused by childhood trauma and repressed memories. They could well be, but many would disagree. That's just one hypothesis. 
It would be nice to raise the evidential standards on this page a little, if not to the level of mainstream medical pages, at least a bit higher. I've made a few attempts, but would welcome feedback and further contributions. Things I found concerning (you might spot others):
 - there is no scientific consensus as to what causes PNES. We have various theories - all quite different - but they are no more than that. In some places, theory was presented as fact, and this is a bad look.
 - there is some evidence to support a role for past trauma, and some to support a role for personality characteristics. But also plenty of studies that support neither.. Need to show balance here.
 - when describing theories that are contentious and widely disputed, the phrasing didn't always make that clear.  e.g., Instead of "PNES are caused by childhood abuse", better to say "One theory is that PNES are caused by childhood abuse" (then give supporting evidence and alternative views)
Further suggestions, feedback welcome.  — Preceding unsigned comment added by Wilshica (talk • contribs) 01:35, 20 July 2015 (UTC)
thread_title:  Trying to introduce a note of caution and balance 

message: Hello PNES editors,
I am a medical student at Tel Aviv University who was assigned this article as part of a wikimed elective course. This article is currently listed as "start-class" so I intend to contribute new portions (e.g. causes, mechanism, pathophysiology, etc.) in an appropriate format. I am collaborating with a member of the ILEA to facilitate neutral improvements. Please reach out to me with comments/questions/concerns regarding my edits.Gomer2 (talk) 18:59, 28 February 2018 (UTC)
replies: text: Sounds good. And welcome. Doc James (talk · contribs · email) 20:05, 3 June 2018 (UTC)
thread_title:  Wiki Project Med student editor 

message: * 
* 
Unclear if these are used in the article as references? Doc James (talk · contribs · email) 20:05, 3 June 2018 (UTC)
thread_title: Moved here

message: Hello all,
I am an undergraduate student studying psychology and am in my fourth year. I have been researching PNES for all four years of my undergraduate career and will be making edits to this article under the supervision of my PI and a PhD student. My main goals for this article are to update the citations and ensure the citations come from credible scientific sources, among other things. I am linking my sandbox here: https://en.wikipedia.org/wiki/User:SkyM99/Psychogenic_non-epileptic_seizure for anyone to review who may be concerned/interested in my change ideas. This is obviously a work-in-progress and I am still a student, I believe everyone is still a student in this topic, so bear with me!  — Preceding unsigned comment added by SkyM99 (talk • contribs) 19:28, 21 March 2021 (UTC)
thread_title:  Wiki Edit Class Project 

message: There has been a follow-up study regarding the ReACT treatment for PNES (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8633863/). Could anybody more versed in this topic than I include this information in the article?  — Preceding unsigned comment added by 2003:DC:1F2F:34E8:7422:6787:E37E:F460 (talk) 00:27, 7 January 2022 (UTC)
thread_title:  Follow-up for ReACT treatment 

message: Removed the following claim in "signs and symptoms:"
: PNES episodes are nearly indistinguishable from epileptic seizures. The main differences between a PNES episode and an epileptic seizure is the duration of episodes. Epileptic seizures typically last between 30 and 120 seconds depending on the type, while PNES episodes typically last for two to five minutes.
which was contradicted by the following in "diagnosis:"
: Some features are more or less likely to suggest PNES but they are not conclusive and should be considered in the broader clinical picture. Features that are common in PNES but rarer in epilepsy include: biting the tip of the tongue, seizures lasting more than two minutes (easiest factor to distinguish), seizures having a gradual onset, a fluctuating course of disease severity, the eyes being closed during a seizure, and side to side head movements. Features that are uncommon in PNES include automatisms (automatic complex movements during the seizure), severe tongue biting, biting the inside of the mouth, and incontinence.
: If a person with suspected PNES has an episode during a clinical examination, there are a number of signs that can be elicited to help support or refute the diagnosis of PNES. Compared to people with epilepsy, people with PNES will tend to resist having their eyes forced open (if they are closed during the seizure), will stop their hands from hitting their own face if the hand is dropped over the head, and will fixate their eyes in a way suggesting an absence of neurological interference.
Moved all of this info from diagnosis into signs and symptoms, and added more details and sources.
Removed the following from "treatment," overly detailed and not sourced at all.
: Eight points recommended to explain the diagnosis to the person and their caregivers are:
:* Reasons for concluding they do not have epilepsy
:* What they do have (describe functional neurological disorder)
:* Emphasize they are not suspected of "putting on" the attacks, and the symptoms are not "all in their head"
:* There may be no triggering "stresses"
:* Maintaining factors
:* May improve after correct diagnosis
:* Caution that anticonvulsant drug withdrawal should be done in conjunction with their physician
:* Describe treatment to help regain control of symptoms
Removed the following paragraph from "prognosis." The first sentence is directly contradicted by its own source; the others are all sourced from studies from the 90s. Treatment for PNES has greatly improved over the last 30 years, and studies from the 90s of untreated PNES patients aren't good sources for modern PNES prognosis. 
: Functional seizures have been found to be as disabling and costly as epilepsy. Though there is limited evidence, outcomes appear to be relatively poor with a review of outcome studies finding that two-thirds of people with PNES continue to experience episodes and more than half are dependent on the Social Security program at three-year follow-up. This outcome data was obtained in a referral-based academic epilepsy center and loss to follow-up was considerable; the authors point out ways in which this may have biased their outcome data. Outcome was shown to be better in people with higher IQ, social status, greater educational attainments, younger age of onset and diagnosis, attacks with less dramatic features, and fewer additional somatoform complaints.
137.22.90.64 (talk) 08:01, 27 May 2024 (UTC)
thread_title:  Removal of bad information in signs and symptoms, treatment, and prognosis