Case 2 Paulina Pocket a 32-year-old single African American woman with epilepsy first diagnosed during adolescence. She was admitted to a medical center after her family found her convulsing in her bedroom. During her hospital admission, a routine electroencephalogram (EEG) was ordered. Shortly after the study began, Ms. Pocket began convulsing. When the EEG was reviewed, no epileptiform activity was identified. Ms. Pocket was subsequently placed on video-EEG (VEEG) monitoring. In the course of her monitoring, Ms. Pocket had several episodes of convulsive motor activity; none were associated with epileptiform activity on the EEG. Psychiatric consultation was requested. Ms. Pocket noted that she had recently moved to the state to start graduate school; she was excited to start her studies and "finally get my career on track." She denied any recent specific psychosocial stressors other than her move and stated, "My life is finally where I want it to be." She was worried about missing the first day of classes (only a week away from the time of the interview). She was also worried about the costs of her hospitalization because her health insurance coverage did not begin until the school semester commenced. When the findings of the VEEG study were discussed with Ms. Pocket, she quickly became quite irritable asking, "So, everyone thinks I'm just making this up?" The psychiatrist/clinician tried to ease Ms. Pocket's concerns by telling her that about 10% of people with epilepsy also experience non-epileptic seizures (NES). NES can be caused by subconscious thoughts, emotions or 'stress', not abnormal electrical activity in the brain. Professionals do not believe that the seizures are purposely or fictitiously produced. The clinician told Ms. Pocket, she, would not be exposed to unnecessary medication or studies, and that treatment, in the form of psychotherapy, was available.

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Case 2
Paulina Pocket a 32-year-old single African American woman with epilepsy first diagnosed during
adolescence. She was admitted to a medical center after her family found her convulsing in her
bedroom.
During her hospital admission, a routine electroencephalogram (EEG) was ordered. Shortly after
the study began, Ms. Pocket began convulsing. When the EEG was reviewed, no epileptiform
activity was identified. Ms. Pocket was subsequently placed on video-EEG (VEEG) monitoring. In
the course of her monitoring, Ms. Pocket had several episodes of convulsive motor activity; none
were associated with epileptiform activity on the EEG. Psychiatric consultation was requested.
Ms. Pocket noted that she had recently moved to the state to start graduate school; she was
excited to start her studies and "finally get my career on track." She denied any recent specific
psychosocial stressors other than her move and stated, "My life is finally where I want it to be." She
was worried about missing the first day of classes (only a week away from the time of the
interview). She was also worried about the costs of her hospitalization because her health
insurance coverage did not begin until the school semester commenced.
When the findings of the VEEG study were discussed with Ms. Pocket, she quickly became quite
irritable asking, "So, everyone thinks I'm just making this up?" The psychiatrist/clinician tried to ease
Ms. Pocket's concerns by telling her that about 10% of people with epilepsy also experience
non-epileptic seizures (NES). NES can be caused by subconscious thoughts, emotions or 'stress', not
abnormal electrical activity in the brain. Professionals do not believe that the seizures are
purposely or fictitiously produced. The clinician told Ms. Pocket, she, would not be exposed to
unnecessary medication or studies, and that treatment, in the form of psychotherapy, was
available.
Transcribed Image Text:Case 2 Paulina Pocket a 32-year-old single African American woman with epilepsy first diagnosed during adolescence. She was admitted to a medical center after her family found her convulsing in her bedroom. During her hospital admission, a routine electroencephalogram (EEG) was ordered. Shortly after the study began, Ms. Pocket began convulsing. When the EEG was reviewed, no epileptiform activity was identified. Ms. Pocket was subsequently placed on video-EEG (VEEG) monitoring. In the course of her monitoring, Ms. Pocket had several episodes of convulsive motor activity; none were associated with epileptiform activity on the EEG. Psychiatric consultation was requested. Ms. Pocket noted that she had recently moved to the state to start graduate school; she was excited to start her studies and "finally get my career on track." She denied any recent specific psychosocial stressors other than her move and stated, "My life is finally where I want it to be." She was worried about missing the first day of classes (only a week away from the time of the interview). She was also worried about the costs of her hospitalization because her health insurance coverage did not begin until the school semester commenced. When the findings of the VEEG study were discussed with Ms. Pocket, she quickly became quite irritable asking, "So, everyone thinks I'm just making this up?" The psychiatrist/clinician tried to ease Ms. Pocket's concerns by telling her that about 10% of people with epilepsy also experience non-epileptic seizures (NES). NES can be caused by subconscious thoughts, emotions or 'stress', not abnormal electrical activity in the brain. Professionals do not believe that the seizures are purposely or fictitiously produced. The clinician told Ms. Pocket, she, would not be exposed to unnecessary medication or studies, and that treatment, in the form of psychotherapy, was available.
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