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Table 5 Crib sheet with 14 core points for the strategy of PNES diagnosis communication to a patient (Adapted from the work of Hall-Patch et al. (2009), with permission) [38]

From: The first-line management of psychogenic non-epileptic seizures (PNES) in adults in the emergency: a practical approach

- Confirm that the symptoms are authentic
Real attacks: can be frightening or disabling
- Define a label
Give a name for the condition
Give alternative names (not offensive) that the patient can easily understand
Reassure that it is a common and recognized condition
- Explain the causes and the maintaining factors
No epilepsy
Predisposing factors: it is difficult to find causes
Precipitating factors: can be linked to stress / emotions
Perpetuating factors: vicious circle consisting in - worry → stress → attacks → worry
Provide a model for the attacks – e.g., the brain becomes overwhelmed and shuts down
- Explain the treatment
Antiepileptic drugs will not be effective
Present the proofs that psychological treatment is effective
Talk to the patient about referral to a specialist
- Guide the expectations
PNES episodes can resolve
Improvement can be expected