Psychogenic Non-Epileptic Seizures

Purpose of Review In this review, we elucidate the evaluation process involved in the diagnosis of psychogenic non-epileptic seizures (PNES). Minimum clinical criteria required to attain this diagnosis via a staged approach are delineated. The psychological underpinnings and management of PNES from the neurologists' perspective are also explored. Recent Findings Helpful clues can be deduced from historytaking, seizure semiology, ictal/peri-ictal physical exam, and ictal/inter-ictal EEG data. No single clinical data point is definitively diagnostic of PNES. Instead, the level of certainty for PNES diagnosis is contingent upon concordance of the composite clinical evidence available. Robust neurologistpatient alliance not only facilitates the evaluation process but can influence therapeutic impact. Summary While diagnosis of PNES can be challenging, this diagnosis can be reliably made upon establishing concordance of the historical, physical exam, and video-EEG findings. Evidence-based treatments are available for pa-tients with PNES. Continued efforts remain necessary to enhance timely diagnosis and interdisciplinary management for patients with PNES.