Neurology specialists’ visual interpretation of psychogenic nonepileptic seizures: Contemplating their etiology and existing challenges

Abstract

PurposeThe purpose of this study was to explore how neurology specialists with interest in epilepsy depict psychogenic nonepileptic seizures (PNES) and their experience of diagnosing and treating the disorder. MethodsAn art project was organized as part of the curriculum of the 14th Latin American Summer School on Epilepsy (LASSE) in São Paulo (Brazil) from February 27th to March 6th, 2020. Willing neurologists were invited to draw or paint PNES and present their professional perspective of this disorder. Grouped by common themes, the artworks were analyzed in the context of the existing literature on PNES. ResultsThe participants created 31 paintings and drawings, 13 of which were selected to represent the recurring themes. Throughout the artworks, neurologists often portrayed PNES as masking the underlying psychological issues, but there was little emphasis on the genesis of PNES itself. The manifestation of PNES was more attributed to just emotional suppression rather than to the influence of different situational factors on a pre-established seizure scaffold. Considering the management of PNES, neurology specialists used the symbol of a labyrinth to represent the difficulties of effectively providing diagnosis and multidisciplinary care for the patients. The general outlook on PNES was associated with darkness, possibly due to limited understanding of the disorder’s nature and the unavailability of effective treatment options. ConclusionOur study shows that art projects can be useful to better grasp neurology specialists’ opinions about a certain disorder. Further research is needed to elucidate the mechanisms of PNES and help establish multidisciplinary care.