RESUMEN
OBJECTIVE: This study examined the psychiatric and neuropsychological profiles of people with psychogenic nonepileptic seizures (PNES). METHODS: Twenty-people who had been diagnosed with psychogenic nonepileptic seizures (PNES), but not epilepsy, were recruited into this study. A healthy control group was also recruited and was matched for age and gender. All participants underwent structured psychiatric assessment and psychometric assessment. Neuropsychological assessment was carried out using the Cambridge Neuropsychological Test Battery (CANTAB) after participants passed the Medical Symptom Validity Test (MSVT) of effort. RESULTS: One patient failed the MSVT and was excluded from the analysis. Therefore, data from 19 people with PNES and their matched healthy controls were analyzed. Compared with controls, people with PNES had significantly higher levels of depressive symptoms, anxiety symptoms, dissociative experiences, and alexithymic traits. In addition, people with PNES had impairments in spatial working memory and attention when compared with healthy controls. CONCLUSION: To our knowledge, this is the first study to report that, compared with controls, people with PNES have abnormal cognitive functioning after controlling for effects of effort and FSIQ. People with PNES also have high levels of anxiety, depressive, and dissociative symptoms. In addition, they appear to particularly focus on health problems and show evidence of chronic emotional dysregulation. Further studies are required to replicate our results and to help clarify the pathogenic mechanisms underlying PNES.
Asunto(s)
Trastornos Mentales/psicología , Trastornos Psicofisiológicos/psicología , Convulsiones/psicología , Adulto , Síntomas Afectivos/etiología , Síntomas Afectivos/psicología , Ansiedad/etiología , Ansiedad/psicología , Atención , Comorbilidad , Trastorno Depresivo/etiología , Trastorno Depresivo/psicología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos Disociativos/etiología , Trastornos Disociativos/psicología , Femenino , Humanos , Masculino , Trastornos de la Memoria/etiología , Trastornos de la Memoria/psicología , Trastornos Mentales/etiología , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Trastornos Psicofisiológicos/etiología , Convulsiones/complicacionesRESUMEN
129 Wada procedures were reviewed to examine the suitability of propofol (n=54) as a replacement to amobarbital (n=75) for use as an anaesthetic in the Wada test. Suitability was considered with respect to length of hemiplegia induced, the frequency of side effects and patient memory scores. Data was retrospectively collected from records of patients who had undergone the Wada procedure between 2004 and 2009 in Beaumont Hospital, Dublin. No significant differences were found between the two drugs on any of the measures. The results suggest that propofol represents a suitable alternative to amobarbital for use in the Wada procedure.
