According to Johns Hopkins researchers, patients with “stress seizures” are often misdiagnosed.

A team of Johns Hopkins physicians and psychologists say that more than one-third of the patients admitted to The Johns Hopkins Hospital’s inpatient epilepsy monitoring unit for treatment of intractable seizures have been discovered to have stress-triggered symptoms rather than a true seizure disorder.

These patients — returning war veterans, mothers in child-custody battles and over-extended professionals alike — have what doctors are calling psychogenic non-epileptic seizures (PNES). According to Johns Hopkins researchers, these displays of uncontrollable movements, far-off stares or convulsions are not the result of the abnormal electrical discharges in the brain that characterize epilepsy. Instead these symptoms appear to be stress-related behaviors that mimic epilepsy and are often misdiagnosed by clinicians.

In the past, behaviors like PNES were called “hysteria.” Now they are often considered by psychiatrists as part of an emotional reaction to overwhelming stress, in which the patient unconsciously converts emotional dysfunction into physical symptoms. In some cases, those afflicted have become paralyzed or blind because of emotional trauma.

In a new study, a team of neuropsychologists and neurologists at the Johns Hopkins University School of Medicine suggest that people with PNES don’t necessarily experience more frequent or severe stressful events than people with epilepsy or neurologically healthy people. However, these individuals may lack effective coping mechanisms necessary to deal with those stresses and as a result, feel more distressed by them.

“These patients behave as if they have an organic brain disease, but they don’t,” says Jason Brandt, Ph.D., the study’s senior investigator and a professor of psychiatry and behavioral sciences and neurology at the Johns Hopkins University School of Medicine. “And it turns out that their life stresses weren’t all that high, but they’re very sensitive to stress and they don’t deal with it well.”

The Johns Hopkins researchers say they undertook the new study in an effort to learn why “psychogenic” symptoms so closely simulate a physical disorder and why some people are more susceptible to these behaviors than others. The study was published online in the journal Seizure. 

Gregory L. Krauss, M.D., a professor of neurology at Johns Hopkins and one of the study’s co-authors, says he is surprised by how many patients are being referred to his epilepsy unit without having epilepsy at all. According to Dr. Krauss, “There’s a lot of stress out there in our modern society, and this research highlights that many people don’t have the skills to cope with that.”

And the numbers appear to be growing. He says that in recent months, as many as half of those referred to the unit have pseudo-seizures. ”We’re just seeing a large number of these patients, and we’ll probably see more of them,” said Krauss.

April 13, 2012
The Healthy Mind Network 

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The above story contains original content and/or information reprinted and editorially adapted by The Healthy Mind. Material is provided by the Johns Hopkins Medical Institutions and EurekAlerts. 

Image Credit: Ammgramm 

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