Abstrakt
Psychogenic non-epileptic seizures (PNES) are a specific disease that is correctly diagnosed and therefore explicitly distinguished from epilepsy with the usual latency of several years. The gold diagnostic standard is a long-term video-electroencephalographic examination, which, however, is not commonly available in present medical conditions.
Misdiagnosis occurs usually in PNES patients with a history of psychotraumatization, whose seizure often have a dramatic course resembling a generalized epileptic seizure. With these patients, the summoned emergency medical service usually assume epileptic genesis due to a rapid clinical evaluation and a lack of anamnestic information and initiates treatment of epileptic status, thus challenging the diagnosis.
Repeated re-evaluation of the diagnosis and inconsistent conclusions may complicate psychological treatment and may lead to the cooperation of the patient. PNES, as an interdisciplinary disease, requires high demands on the expertise of the patienťs therapists.
Although the psychologist / psychotherapist has a crucial role in the PNES treatment, in the case of re-evaluation of the diagnosis, the psychologist/psychotherapist relies on the conclusions of doctors from the field of neurology, psychiatry or other specializations relevant for the patient. The submitted paper focuses on the description of the issues related to the psychological treatment of patients with PNES.
Among the most common issues belong frequent challenging of the determined diagnosis by doctors, who are not experienced in PNES, which lead to the patient's low trust in the healthcare system, as well as non-acceptance of the diagnosis by patients and their relatives. The paper also discusses the possible solutions of mentioned issues, emphasizing the importance of establishing cooperation with the patient during the first contact, multidisciplinary cooperation, individual psychotherapeutic approach with patient and the patients family.