Improving Recognition, Diagnosis of Psychogenic Nonepileptic Seizures: Becky Tilahun, PhD


The clinical psychologist at Cleveland Clinic provided insight on the tricky nature of diagnosing a patient with nonepileptic seizures and the difficult conversations that can ensue. [WATCH TIME: 3 minutes]

WATCH TIME: minutes

"From the provider side, there’s a lot that we can do to help our patients listen to the new diagnosis and accept it in a way that helps them to follow-up with a recommendation by their providers."

A recently conducted study found the use of Cognitive Behavioral Therapy-informed psychotherapy, or CBTip, to significantly improve seizure frequency, anxiety, and depression, in patients with psychogenic non-epileptic seizures (PNES) who undergo the counseling for up to 1 year. Those who attended a CBTip program for a minimum of 7 visits within 90 days did not show a significant change on treatment outcomes, indicating that treatment effect with this intervention may occur over a longer period of time.

This form of psychological counseling has been found to be an effective intervention for management of PNES and addressing its underlying symptoms; however, many patients with the disease remain untreated and symptomatic. Lead author Becky Tilahun, PhD, clinical psychologist, Cleveland Clinic, noted that while a large majority of epileptologists are sufficient in identifying and diagnosing patients, the delivery of the diagnosis is the most crucial aspect, considering that these patients are already dealing with a disorder that stems from psychological distress.

In an interview with NeurologyLive®, Tilahun discussed the need for medical providers, not just neurologists, to learn better ways of speaking and revealing diagnosis to patients with PNES. She also stressed that empathy and compassion shown during these conversations may ultimately improve the trust shared between patient and provider and the outcomes of those with PNES.

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