Medical Trauma in a Young Adult with Psychogenic Nonepileptic Seizures (ReACT)- Chelsea Ross Miller

Co-Authors: Chelsea R Miller, MD, Psychiatry, PGY3, University of Alabama Birmingham, Birmingham, AL; Melissa Greenfield, PsyD, Assistant Professor, Psychiatry, University of Alabama Birmingham, Birmingham, AL
Introduction:Introduction:
Psychogenic nonepileptic seizures (PNES) are the most common type of functional neurological disorder (FND). PNES is associated with chronic disability and welfare dependence. Studies have shown that anti-epileptic drugs do not improve symptoms burden, and cognitive behavioral therapy results in limited reduction of symptoms. Prolonged episodes occur in 78% of patients with PNES and are often misdiagnosed in the ER as status epilepticus, resulting in large doses of benzodiazepines, and iatrogenic respiratory depression leading to ICU admissions. Retraining and control therapy (ReACT) is a newly developed manualized mind-body intervention that has shown reduction in symptoms for pediatric PNES. In this case, it is applied to a young adult with medical trauma from ICU admissions for PNES.
1. Fobian, A. D., & Szaflarski, J. P. (2021). Retraining and Control Therapy (ReACT) is a bottom-up, body-oriented intervention. Seizure, 92, 236-237. doi.org/10.101...
2. LaFrance, W. C., Jr., et al. (2014). "Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial." JAMA psychiatry 71(9): 997-1005.
3. Goldstein, L. H., et al. (2010). "Cognitive-behavioral therapy for psychogenic nonepileptic seizures: a pilot RCT." Neurology 74(24): 1986-1994.
4. Haritsa, S. V., et al. (2021). "Randomized Trials of Psychotherapeutic Treatment for Psychogenic Seizures: Scoping Review." Indian J Psychol Med 43(6): 469-472.
5. Jungilligens, J., et al. (2021). "Misdiagnosis of prolonged psychogenic non-epileptic seizures as status epilepticus: epidemiology and associated risks." J Neurol Neurosurg Psychiatry 92(12): 1341-1345.