Metopic Craniosynostosis, Paroxysmal Dyskinesias, and Conversion Disorder in an Early Adolescent..

Transcribed from my older blog.

I’m honored to be presenting a poster version of my published case report (co-authored with Dr. Buneviciute and Dr. Rice) at the 2020 annual meeting of the American Psychiatric Association in Philadelphia. This post is the landing site of the QR code I’m including on the poster, so interested parties can check out the published paper, peruse the poster References list and read the APA abstract. If you’re coming to APA and want to come by my poster in person, here are the session details:

Session: Poster Session 4 Date: Sunday, April 26, 2020 Time: 9:30 AM–10:30 AM Poster Number: P4-141 Poster Title: Metopic Craniosynostosis, Paroxysmal Dyskinesias, and Conversion Disorder in an Early Adolescent with Depression

APA Abstract Psychogenic non-epileptic seizures (PNES) are a subset of conversion disorders of particular interest due to their similarity in presentation to epilepsy and relatively frequent comorbidity with neurologic diagnoses. Nearly half of children with PNES also have a positive neurological history (most commonly epilepsy or history of traumatic brain injury). In turn, such patients with dual psychiatric and neurologic diagnoses, who may be receiving overlapping treatment for both types of disorders, present additional complexity when adjusting treatment plans. We present an interesting case of a patient with pre-existing paroxysmal movement disorder and a birth history significant for skull abnormality, who later later developed PNES with multiple variations in presenting symptoms. At initial encounter, N. was a 13-year-old girl of normal educational attainment level with a history of depression, paroxysmal dyskinesia/choreoathetosis, and juvenile onset glaucoma recently diagnosed with PNES. She was referred for increasing frequency and intensity of violent behavior toward herself and family members during episodes consistent with pseudoseizures. The poster illustrates the complexities of diagnosis and treatment of functional neurological symptoms in the context of comorbid neurological and psychiatric illness in an adolescent. Important pharmacological considerations and relevant side effects are highlighted.

References for the poster Fossati et al. Alexithymia and attachment insecurities in impulsive aggression. Attachment & Human Development 2009.

Grabe et al. Alexithymia and Personality in Relation to Dimensions of Psychopathology. Am J Psychiatry 2004.

Myers et al. Prolonged exposure therapy for the treatment of patients diagnosed with psychogenic non-epileptic seizures (PNES) and post-traumatic stress disorder (PTSD). Epilepsy & Behavior 2017.

Owens and Dein. Conversion disorder: the modern hysteria. Advances in Psychiatric Treatment 2006.

Pop-Jordanova et al. Electrodermal biofeedback in treating psychogenic nonepileptic seizures. Prilozi 2005.

Wilson et al. Age of onset and course of major depressive disorder. Psychological Medicine 2015. Edit Apr 30, 2020: Since APA 2020 was cancelled, I'm posting the poster pdf here..

APA2020_GenYangDraftv2.pdf

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