Dissociative Convulsion

Dissociative Convulsion

Dissociative convulsions, often referred to as Psychogenic non-epileptic seizures (PNES), non-epileptic attack disorders (NEAD), or non-epileptic attack syndromes, are seizures that resemble epileptic seizures but lack the distinctive electrical discharges connected with epilepsy.

There is no agreed-upon scientific theory for the origin of PNES. However, many medical professionals think psychological issues may be the cause of the disease (irrespective of whether the patient shows any obvious psychological distress or pathology). PNES is thought to be present in 20% of seizure patients seen at specialized epilepsy clinics.

Causes

• Amnesia refers to the loss of memory for certain persons, events, and times.
• Mental health issues including despair, anxiety, and attempts and thoughts of suicide.
• A feeling of detachment from oneself A belief that the people and things in your immediate environment are distorted and unreal.
• No clear idea of who you are.
• Significant anxiety or issues at work, in your relationships, or in other crucial areas of your life.

Sign and Symptoms 

• Memory loss (amnesia) of specific people, events, and times.
• Suicidal thoughts and attempts, as well as mental health issues like depression and anxiety
• A perception of your surroundings as distorted and unreal A feeling of detachment from yourself.
• Identities that are unclear.
• problems or significant stress in your relationships, career, or other important areas of your life.

Diagnosis

• Tests to rule out physical conditions — for example, head injury, certain brain diseases, sleep deprivation or intoxication
• Diagnostic and Statistical Manual of Mental Disorders (DSM)

Treatments

• This must be clear and coherent as attributing physical symptoms to a psychological cause is not accepted by many educated people in western cultures. It must emphasize the genuineness of the condition, that it is common, potentially reversible and does not mean that the sufferer is psychotic. Taking an etiologically neutral stance by describing the symptoms as functional may be helpful but further studies are required. Ideally, the patient should be followed up neurologically for a while to ensure that the diagnosis has been understood.
• Physiotherapy where appropriate;
• Occupational Therapy to maintain autonomy in activities of daily living;[35]
• Treatment of comorbid depression or anxiety if present.

Nursing Management

• Provide safe environment; protect client/others from injury.
• Assist client to recognize anxiety.
• Promote insight into relationship between anxiety and development of dissociative state/other personalities.
• Support client/family in developing effective coping skills and participating in therapeutic activities.
• Relief obtained from admitting physical symptom(s).
• Client/family recognizes relationship between psychological stressors and onset/exacerbation of physical symptoms(s).
• Stress management techniques used appropriately to prevent the occurrence/exacerbation of the physical symptom(s).
• Level of function/independence increased.
• Plan in place to meet needs after discharge.