Pseudo-Neurologic Disorders

Pseudo-neurologic disorders (PNDs) are clinical complaints most often mistaken as signs of known neurological disease or injuries, such as epilepsy, movement disorders, cognitive disorders, neurotoxic exposures, and various pain syndromes. They are not distinct unified diseases and in the extant literature they are variously referred to as pseudo-seizures, non-epileptic seizures, psychogenic non-epileptic seizures (PNEs), non-epileptic attach disorders, hysterical fits, functional movement disorders, psychogenic movement disorders, psychigenic pain disorder, conversion disorder, and approximately 15 other synonyms. The clinical phenomenon of the PNDs has a long and fascinating history and fired the imagination of all of the seminal 19th and early 20th century pioneers of modern neurology and psychiatry; Charcot, Freud, Breuer, Janet, and others. Today it still has the power to command our attention and raises difficult questions about consciousness, volition, and intention. In the past 20 years there has been a great deal of scholarship and research in the field, and a greater appreciation of its importance has emerged.
Moreover, there has been an explosion of knowledge in clinical neuroscience which has vastly improved our diagnostic and therapeutic capability. However, an orderly understanding of the PNDs has been more elusive. The most likely reasons for this gap are that the PNDs are wildly heterogeneous and are typically classified either as symptoms of an underlying psychiatric disorder or in terms of their superficial resemblance to the various neurologic diseases for which they are mistaken. Hence, PNDs, like other somatizations, have come to be defined in terms of what they are not rather than what they are. This volume will provide practicing physicians and clinical neuroscientists with a one-source guide to the differential diagnosis and management of the most frequently encountered pseudo-neurologic disorders.