Rethinking Seizure Care Blog

Perceptions by Healthcare Providers of Psychogenic Nonepileptic Seizures

Posted by RSC Diagnostics on Apr 18, 2019

Doctor and middle aged patient talking to each other during visit in the office-1

The relationship that a patient has with their doctor is far more important than many people realize when it comes to the outcome of the patient. The patient has to put a lot of trust in their doctors and other healthcare providers, which is not always easy. This is especially true for those patients who have somatic symptoms and similar types of disorders that don’t have “traditional” manifestations.

Problems Caused by PNES

Psychogenic nonepileptic seizures are one of the most common types of these conditions. This functional neurological disorder can show up in patients and is often believed to be due to epilepsy, at least initially. When the patient is examined, they will show no signs of epilepsy, but they might still be misdiagnosed. When patients show no signs of epilepsy, those around them, even their healthcare providers, may tend to question whether they are truly suffering from seizures or not.

This element of distrust is very difficult for the patients to bear. If there is lack of trust between the patient and their healthcare provider, friction and problems may begin to occur. In result, neither party will be happy or trust what each other is saying, increasing the number of problems substantially.

Often times, the outcome is the patient will not be provided the care that they need and may be misdiagnosed. A misdiagnosis may result in placement for antiepileptic medication that they don’t need, which could cause side effects. Additionally, it could increase the risk of medicolegal issues arising.

Patients often decline and begin to feel like they're treated poorly or not being heard. Many patients will stop going to the doctor because they feel that they are not being taken seriously and that the doctor does not care about what happens to them.

These problems will often stem from the fact that the medical professionals don't know enough about PNES or how to speak with the patients properly. There are several cases where the doctor, even if they are trying to be reassuring, tells the patient that they don’t have “real seizures.” This does not alleviate the worry of the patients nor does it help them with what they are going through.

Studies have shown that the language used matters greatly when it comes to patient and provider trust and the patient outcome.

Communication Matters

Doctors and other healthcare providers need to make sure that they are listening. An area where the providers need to make improvements is by the way they communicate if they truly want to help the patients. Healthcare providers need to make sure they're not always defaulting to placing patient's on AEDs right away.

The healthcare providers are certainly not solely responsible for the negative patient outcomes. Sometimes, patients themselves do things that cause more harm than good. However, when the providers are able to communicate better with the patients by not using negative language or dismissing the patient outright, it can help to improve the overall outcome for PNES patients.

 

Sources:

https://journals.sagepub.com/doi/full/10.1177/1535759718823798

Topics: Psychogenic Non-Eplieptic Seizures (PNES)