Evidence map›Paper›PMID 28956448›Full record

ArticleClinical child psychology and psychiatry2018

Psychogenic non-epileptic seizures in children and adolescents: Part I - Diagnostic formulations.

Kasia Kozlowska, Catherine Chudleigh, Catherine Cruz, Melissa Lim, Georgia McClure, Blanche Savage, Ubaid Shah, Averil Cook, Stephen Scher, Pascal Carrive and 1 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical child psychology and psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 57 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Kasia Kozlowska1 Department of Psychological Medicine, The Children's Hospital at Westmead, NSW, Australia.
Catherine Chudleigh1 Department of Psychological Medicine, The Children's Hospital at Westmead, NSW, Australia.
Catherine Cruz1 Department of Psychological Medicine, The Children's Hospital at Westmead, NSW, Australia.
Melissa Lim1 Department of Psychological Medicine, The Children's Hospital at Westmead, NSW, Australia.
Georgia McClure1 Department of Psychological Medicine, The Children's Hospital at Westmead, NSW, Australia.
Blanche Savage1 Department of Psychological Medicine, The Children's Hospital at Westmead, NSW, Australia.
Ubaid Shah3 Sydney Medical School, The University of Sydney, NSW, Australia.
Averil Cook1 Department of Psychological Medicine, The Children's Hospital at Westmead, NSW, Australia.
Stephen Scher3 Sydney Medical School, The University of Sydney, NSW, Australia.
Pascal Carrive8 Department of Anatomy, School of Medical Sciences, University of NSW, Australia.
Deepak Gill3 Sydney Medical School, The University of Sydney, NSW, Australia.
Children's Hospital at Westmead · AUUniversity of Sydney · AUUNSW Sydney · AUWestmead Institute for Medical Research · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Psychogenic non-epileptic seizures (PNES) are a nonspecific, umbrella category that is used to collect together a range of atypical neurophysiological responses to emotional distress, physiological stressors and danger. Because PNES mimic epileptic seizures, children and adolescents with PNES usually present to neurologists or to epilepsy monitoring units. After a comprehensive neurological evaluation and a diagnosis of PNES, the patient is referred to mental health services for treatment. This study documents the diagnostic formulations - the clinical formulations about the probable neurophysiological mechanisms - that were constructed for 60 consecutive children and adolescents with PNES who were referred to our Mind-Body Rehabilitation Programme for treatment. As a heuristic framework, we used a contemporary reworking of Janet's dissociation model: PNES occur in the context of a destabilized neural system and reflect a release of prewired motor programmes following a functional failure in cognitive-emotional executive control circuitry. Using this framework, we clustered the 60 patients into six different subgroups: (1) dissociative PNES (23/60; 38%), (2) dissociative PNES triggered by hyperventilation (32/60; 53%), (3) innate defence responses presenting as PNES (6/60; 10%), (4) PNES triggered by vocal cord adduction (1/60; 2%), (5) PNES triggered by activation of the valsalva manoeuvre (1/60; 1.5%) and (6) PNES triggered by reflex activation of the vagus (2/60; 3%). As described in the companion article, these diagnostic formulations were used, in turn, both to inform the explanations of PNES that we gave to families and to design clinical interventions for helping the children and adolescents gain control of their PNES.

Indexed as

AdolescentChildEmotionsFemaleHumansMalePsychophysiologic DisordersSeizuresconversion disorderdissociationdissociative convulsionsfunctional neurological symptom disorderPsychogenic non-epileptic seizuresstress seizures

Identifiers

PMID28956448
PMCPMC5757410
OpenAlexW2757622442

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.