Epilepsy and Functional Neurological Disorders
epilepsy
affects the brain and causes seizures (electrical activity in the brain that temporarily affect how it works)
seizures can cause a wide range of symptoms and can affect people in different ways depending which part of the brain is involved
usually lifelong condition, can live normal lives if seizures are well controlled
seizures include zoning out but remaining aware but unable to explain at the time
can have surgery and other forms of medical treatment
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Non-Epileptic Attack Disorder (NEAD)
episodes of temporary loss of control and/or awareness
symptoms affect
movement - shaking, falls, poor movement control
senses - changes to hearing, sight, taste, smell or touch, feeling numb
awareness/thinking skills - feeling confused, distant, disorientated, black black out
range of comorbid MUS, more common in women, young people, low socioeconomic status
present similarly to epilepsy so hard to tell apart, not caused by electrical activity
functional neurological disorder
neurological symptoms that cannot be accounted for by physical damage to the neurvous system
NEAD is the most common FND presenting to neurology
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journey to diagnosis
engagement is important
fairclough et al. (2013) reasons for lack of engagement and droup-out
disagree with diagnosis
diagnosis has lack of person relevance
deny psychological factors in their life
impairment due to condition - physical not psychological
shame and isolation
NEAD explanatory models
physical manifestation of emotional distress
freudian concept of convesion and later psychodynamic ideas about somatisation
people with NEAD have higher rates of MHP compared with general population and people diagnosed with epilepsy (diprose, 2016)
authors suggest that NEAD is the expression of psycho,ogical distress and thus diagnoses are not distinct conditions
clinical expression of the dissociative type of PTSD
when dissociated, thoughts, feelings and/or memories relating to traumatic events enters the awareness
NEAD is also present in individuals without a known history of trauma (hingray et al., 2011)
NEAD is a hard-wired intrinsic stress response
episode is a physiological reaction to stress much like the fight-flight response that has benefits for survival
NEAD is a learned behaviour
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