Neurologist Questions

“Psychogenic Nonepileptic Seizure Treatment Options”

I am a 27-year-old woman diagnosed with Psychogenic Nonepileptic Seizures. I do not always feel my episodes coming on, but will sometimes feel an aura of numbness and tingling through my legs and arms as well as a rush through my head. My episodes are becoming worse and more frequent. My episodes are painful, I am exhausted all of the time, and I can only eat one meal a day due to nausea. I have not been able to gain employment for months due to liability issues. CBT Therapy has not helped and my medications (Effexor, Hydroxyzine, and Lamictal) have only eased some of the symptoms. What other options do I have for treatment?

Female | 27 years old
Complaint duration: 12 years
Medications: Effexor, Lamictal, Hydroxyzine, Propranolol, Topiramate, Dexilant
Conditions: Psychogenic Nonepileptic Seizures, Sinus Tachycardia, PTSD

2 Answers

There are quite a few questions I think of with your diagnosis and presentation. How was the diagnosis of psychogenic nonepileptic seizures reached. Did you undergo Long term EEG video monitoring and one or several of your events captured  demonstrating no seizure activity?Also have you been evaluated for  vasovagal or neurocardiogenic syncope?. That can often be misinterpreted as PNES ( psychogenic non epileptic seizures). Looking at the Medications you are taking you are being treated for  seizures / mood with Lamictal and Topiramate. Depression and anxiety with Effexor and Hydroxyzine along with CBT. Interactions ( propanolol ) can be used for anxiety, headaches, Tachycardia such as in POTS ( Postural Orthostatic Tachycardia syndrome) or  Vasovagal/ Neurocardiogenic syncope. Dexilant us for reflux heartburn. I suggest you have a visit with your treating physician(s) and discuss in detail your presentation and test results and reevaluate your diagnosis and treatment plans.  Good luck. Dr F. Sent from AOL on Android
I hope youre seeing a psychiatrist, because these medications and your type of seizures are best known to psychiatrists, not neurologists, unlike other seizures. There are multiple medications you havent listed that may well be of help. Even though you have been on the appropriate medications, there are many others to try. You have to be patient and persistent in working with your doctor in finding the medication that works for you. Leon Rosenberg