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SM ISO690:2012 VASILIEVA, Maria, DMITRIEV, Iulia, BEJENARI, Aliona, GORINCIOI, Nadejda, AFTENE, Daniela. The “dual diagnosis” of pharmacoresistant epilepsy and psychogenic non-epileptic seizures. Clinical case. In: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 1, 20-22 octombrie 2021, Chişinău. Chișinău, Republica Moldova: 2021, p. 238. ISBN 978-9975-82-223-7 (PDF).. |
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Cercetarea în biomedicină și sănătate: calitate, excelență și performanță 2021 | ||||||
Conferința "Cercetarea în biomedicină și sănătate: calitate, excelență și performanță" 1, Chişinău, Moldova, 20-22 octombrie 2021 | ||||||
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Pag. 238-238 | ||||||
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Rezumat | ||||||
Background. According to the ICD-10, psychogenic non-epileptic seizures (PNES) are classified as dissociative disorders. Patients with drug-resistant epilepsy are at higher risk of developing PNES, which are diagnosed in 20-30%. Objective of the study. Efectuarea diagnosticului diferențial între crize epileptice și PNES-uri și demonstrarea combinației acestora în “diagnostic dual”. Material and Methods. We present the clinical case of a 42-year-old patient, diagnosed with epilepsy from the age of 13, with focal seizures, with altered awareness and evolution to bilateral tonic, suspected of being drug-resistant on polytherapy with Carbamazepine 1200 mg/day, Levetiracetam 3000 mg/day and Topiramate 50 mg/day. Results. The patient was investigated by brain magnetic resonance imaging - right fronto-basal posttraumatic sequelae, video-EEG monitoring with recording of 2 paroxysmal events: one without electrographic correlation, suspected to be PNES, and other with electrographic correlation - epileptic seizure with frontal semiology. The patient was assessed by a psychologist and psychiatrist with the identification of intra-family conflicts, established moderate global cognitive deficits, anxiety and severe depression. Subsequently the scheme of antiepileptic treatment was modified, antidepressants in combination with psychotherapy sessions was added. Conclusion. In the management of drug-resistant epilepsy it is necessary to consider the possibility of epileptic seizures and PNES. Also, it is important the electrographic correlations on EEG and multidisciplinary team collaboration. |
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Cuvinte-cheie Drug-resistant epilepsy, Psychogenic non-epileptic seizures (PNES), epilepsie farmacorezistentă, crize psihogene non-epileptice (PNES) |
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