How do we know if the treatment is working?

FAQs about psychogenic nonepileptic seizures (PNES)

How do we know if the treatment is working?

Improvement measures vary, but almost always the first measure that the patient and therapist will look at is whether there has been a reduction in the frequency, duration, or intensity of the PNES episodes.

Some patients will experience a reduction in episodes as soon as they receive the diagnosis of PNES and understand and reflect on situations present at the time symptoms began to happen. However, most patients with PNES should complete a course of psychotherapy. Generally, most studies show that more than half of patients experience an improvement after 3 months of psychotherapeutic treatment. Unfortunately, there is a small percentage of patients with PNES (a quarter or less) that may not improve their PNES episodes with the treatments we currently have available.

Some patients may experience a transient increase in episode frequency (especially during the first therapy sessions) as they begin to explore emotions, behaviors, thoughts and life factors related to their symptoms. This does not necessarily mean that "treatment is not working" but rather can be a sign that treatment is beginning to identify some of the factors related to an individual's PNES episodes.

Other areas of improvement seen with participation in treatment and important to focus on:
- Positive changes in quality of life;
- Improvements in coping strategies to address difficult problems that come up in day-to-day life;
- Reduced levels of psychological problems or symptoms (for example, improvement in depressive or anxious symptoms);
- Greater connection with feelings, being less "shut off" and being able to enjoy life more;
- Gaining independence back;
- Being able to return to daily life (work, education, and/or driving).