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I read with interest the article by Tolchin et al. and the accompanying editorial by Dr. Benbadis.1,2 One reason why psychiatrists and psychologists resist accepting the care of patients with psychogenic nonepileptic seizures (PNES) is the failure of the diagnosing neurologist to confirm the diagnosis unequivocally. Many times, we, as epileptologists, are guilty of saying that the patient has PNES, but—because an EEG in the remote past was read as abnormal—a seizure disorder cannot be ruled out. This creates a diagnostic conundrum and treatment dilemma for both the patient and the psychiatrist. Whenever a diagnosis of PNES is made, we—as neurologists—should make a sincere attempt to rule out or rule in coexisting seizure disorder.
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- © 2019 American Academy of Neurology
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