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Tarun Kumar

St. Joseph’s Hospital, Syracuse, USA

Title: Case report: Use of eye movement desensitization and reprocessing (EMDR) for treatment of psychogenic non-epileptic seizures

Biography

Biography: Tarun Kumar

Abstract

Psychogenic non-epileptic seizures (PNES) are sudden, involuntary seizure-like episodes that, unlike epileptic seizures, do not produce electrographic ictal discharges on EEG (electroencephalogram). Symptoms can include changes in behavior, motor, sensory, cognitive and autonomic functions. Psychogenic non-epileptic seizures (PNES) is prevalent in about 20% of children and 40-58% of adults that get evaluated by primary care doctors or at epilepsy centers. It has been estimated that 300,000-400,000 people may suffer from PNES in the United States alone and despite its high prevalence; there is no clear understanding of its etiology, diagnosis, and treatment. Eye movement desensitization and reprocessing (EMDR) is a recent therapeutic modality that is commonly being used to treat patients with posttraumatic stress disorder (PTSD). In this therapy, the patient exposes self to past experiences in brief sessions while focusing on external stimulus. This therapy helps patients to reduce distressing thoughts and feelings and leads to better social functioning. Post-traumatic stress disorder (PTSD), other anxiety disorders, dissociative disorders, depression, and borderline personality disorder are comorbidities frequently encountered in PNES patients. The exact relationship between PTSD and PNES is not clearly understood but it has been hypothesized that traumatic experiences can lead to stress related neurochemical and neuro-anatomic changes leading to dysregulation of stress reactivity in susceptible individuals. This dysregulation can manifest itself in somatoform or conversion-like disorders of which PNES is one. The author will present a case of a 55 year old Caucasian male who was diagnosed with PNES and had been stable on clonazepam 2 mg TID (three times a day) for 5 years but started experiencing side effects (blurry vision) from medication. This patient was successfully treated with EMDR. He was able to taper down his clonazepam significantly without having relapse of his conversion symptoms or side effects.