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]
- 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 |