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Controversies in Neurology
December 2001

The Confluence of Quality of Care, Cost-effectiveness, Pragmatism, and Medical Ethics in the Diagnosis of Nonepileptic Seizures: A Provocative Situation for Neurology

Author Affiliations

From the Department of Neurology, University of Alabama at Birmingham. †Dr Whitaker died August 2001.

 

JOHN N.WHITAKERMD

Arch Neurol. 2001;58(12):2066-2067. doi:10.1001/archneur.58.12.2066

EPILEPSY IS a common neurological disorder. Owing to a combination of clinical observations, technological advances (especially in neuroimaging), sophisticated electrophysiological measurements, and emerging genetic correlations, there have been major advancements in our understanding of the numerous types and subtypes of epilepsy, the utilization of an expanded formulary of antiepileptic drug medications, and an enhanced awareness of the outcomes of various management choices (medical and surgical) made in the treatment of patients with epilepsy. In addition, many nonepileptic medical conditions may give rise to seizures whose recognition and appropriate treatments typically have a marked influence on the successful care of patients with diseases whose origins are toxic, metabolic, infectious, or otherwise. After all of these neurological and medical conditions have been considered, there still remains a large population of patients with nonepileptic seizures (NES) with causes believed to be psychogenic.

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