we have a few patients in our area with Psychogenic Nonepileptic Seizures in our area. I find there is significant misunderstanding and tx of this illness both in paramedicine and in the er. could you explain the disorder and what the recommended tx is in paramedicine and the er 

Psychogenic Nonepileptic Seizures is a complex condition. It used to be termed “Pseduoseizure” and in basic principles is movements that look like a seizure that are NOT from abnormal brain electrical activity (which is the cause of seizures). They can be very difficult to diagnose (requires specialized brain monitoring) and those with PNES can concurrently have epilepsy. Therefore, paramedics should know that this condition exists and can co-exist with epilepsy.  

Paramedics (and the ER as well) should treat with the information that they have in front of them (patient signs and symptoms). Treatment for a seizure should not be withheld for those with a history of PNES. 

Level of Consciousness,Seizure

PNES, Psuedoseizure, Psychogenic Non Epileptic Seizure, seizure

Psychogenic Nonepileptic Seizures (PNES). Epilepsy Foundation. https://www.epilepsy.com/diagnosis/imitators-epilepsy/psychogenic-nonepileptic-seizures