The diagnosis of psychogenic nonepileptic seizures (PNES) is common in epilepsy centers and is a serious condition because these patients may have repeated trials of anticonvulsant medications and emergency department (ED) visits to treat what is believed to be seizures. Video-electroencephalography monitoring enables a definitive diagnosis, although all too commonly other physicians (especially psychiatrists) doubt the findings. Studies have demonstrated efficacy of psychotherapy. These researchers prospectively followed 105 patients with PNES at an academic center who were referred for psychotherapy, either there or in the community.
The researchers reported follow-up data (12–24 months) from 93 participants. The center delivered mindfulness-based behavioral therapy and provided information on the appropriate therapy to community therapists Patients adherent with therapy (i.e., ≥8 sessions within a 16-week period) had a greater decrease in seizure frequency than nonadherent patients (84% vs. 61%), greater improvement in quality of life, and fewer ED visits.