Dissociative Convulsion.pptx

Dissociative convulsion is a mental illness or emergency psychiatric disorder that manifests symptoms like uncontrolled movement and sensation in the body also known as dissociative fits.
The slide explains how dissociative fits differ from epileptic fits and what should be done for management. The table of content includes an introduction, epidemiology, etiology, risk factors, clinical manifestation, differential diagnosis, and emergency nursing management.

1. DISSOCIATIVE CONVULSION

2. Introduction It is also known as hysterical attacks or Epileptic fits It is the ‘Psychogenic Non-Epileptic Seizure ’ In medical practice, it is more appropriate to use the standard and accepted terminology of "psychogenic non-epileptic seizure" (PNES) or "functional non-epileptic seizure" (FNS) when referring to seizure-like events with a psychological origin .

3. It can be defined as the paroxysmal episodes that resemble epileptic seizures but do not result from abnormal electrical activity in the brain . It is caused by psychological condition i.e. there is no any organic cause. Rather, it is caused by psychological factors like stress.

4. Epidemiology Dissociative convulsions are estimated to account for approximately 20% of all referrals to epilepsy centers. The prevalence of epilepsy in the general population is approximately 1% and about 30-50% of all epileptic patients have significant psychiatric problems.

5. Etiology Psychological Origin: Dissociative convulsions arise from psychological factors rather than abnormal brain activity seen in epilepsy. Underlying Stress: Seizures may be triggered by emotional stress, unresolved trauma, or other significant psychosocial factors. Coping Mechanism: The brain converts emotional distress into physical symptoms as a way to cope with overwhelming emotions .

6. Risk Factors Age and Gender: These convulsions can occur at any age but are more common in young adults. Females are more frequently affected than males. Comorbidity: Often, individuals with dissociative convulsions have other psychological conditions, such as anxiety, depression, or trauma-related disorders.

7. Past Trauma: A history of physical or emotional trauma, abuse, or neglect may increase the risk of developing dissociative convulsions. Mental Health Conditions: Individuals with pre-existing anxiety, depression, or other dissociative disorders may have a higher risk. Vulnerable Personality Traits: Certain personality traits, such as high suggestibility, emotional suppression, or difficulty expressing emotions, may contribute to susceptibility.

8. Clinical Manifestations Seizure-Like Movements: Repetitive jerking, thrashing, or shaking movements of the limbs or the entire body. Movements are often rhythmic and may mimic epileptic seizures. Preservation of Awareness: Unlike epileptic seizures, individuals with dissociative convulsions are typically aware of their surroundings during the episode. They may respond to external stimuli, such as their name being called.

9. No Postictal Phase: Following the seizure-like episode, there is usually no period of confusion or exhaustion (postictal phase) as seen in epileptic seizures. Precipitating Factors: Dissociative convulsions are often triggered by emotional stress or psychological trauma. The episodes may be brought on by specific triggers or occur unexpectedly. Provocation Maneuvers: Certain actions or suggestions from healthcare professionals during clinical evaluation can reproduce the convulsions.

10. Differential Diagnosis Distinguishing Dissociative Convulsions from Epileptic Seizures: EEG: Dissociative convulsions show normal brain electrical activity on EEG during the episodes. Lack of Anti-Epileptic Drug Responsiveness: These seizures do not respond to anti-epileptic medications.

11. Difference between Epileptic seizure and Dissociative convulsions

12. Emergency Nursing management Make sure that patient is in safe place. Keep patient in low stimuli environment. If possible, help the patient lie down on a safe and flat surface to prevent injury during the convulsion. Avoid attempting to restrain the patient, as this can increase agitation and stress . Ensure that the patient's airway remains clear and open during the episode. Position the patient's head to the side if they are lying down to prevent choking on saliva or vomit.

13. Rule Out Other Medical Emergencies Assessment of aura symptoms in patient. Give prescribed drugs to the patient such as inj. Dizepam 10 mg I/V or inj. Haloperidol 10 mg I/V slowly. Assess the vital sign to the patient. Make sure there is availability of emergency equipment.

14. Treatment and Management Multidisciplinary Approach: Management involves collaboration among neurologists, psychiatrists, psychologists, and other healthcare professionals. Psychotherapy: Cognitive-behavioral therapy (CBT) and other psychotherapeutic approaches are essential components of treatment.

15. Addressing Underlying Stress: Identifying and addressing psychological triggers and stressors are crucial for recovery. Education and Support: Providing education to patients and their families about the condition and offering support can improve outcomes.