Individual Travel Grants - David Gigineishvili
International league against Epilepsy Neuropsychiatry commission and the Japan Epilepsy Society within the frame of the 49 th Japan Epilepsy Society annual meeting announced for the join meeting discussing the key areas around psychogenic non-epileptic seizures (PNES). The event was held in Nagasaki on 29 th October, 2015. In this meeting, entitled “PNES around the world: let’s learn more about this neglected disorder and see how we might help” various international experts were invited to deliver a lectures aiming to discuss key areas of need and solution to these, to reduce the burden on PNES on individuals and society. Among the speakers from all over the world the Georgian professor Dr.David Gigineishvili from Tbilisi State University was invited. His presentation focused on the results of the PNES Task Force survey performed among the Georgian professionals during this year. The survey showed that overall health professionals (mostly neurologists & epileptologists) are well informed about the diagnosing process. They usually personally deliver the diagnosis to patient, however only minority was followed up. Difficulties with a delivering nonpharmacological treatment options are based on lack of experience and knowledge of physicians in psychotherapy concerning PNES, deficiency of professionals who could perform CBT (cognitive-behavioral therapy) and lack of money for cover this service. The policy of insurance companies and governmental medical programs at this stage do not support patients with paroxysmal events. This discrepancy between willingness of health professionals and absence of resources and trained psychotherapists require necessary intervention in this sphere from health policy makers.
In the first part of the meeting classification and nosological issues were discussed. In particular Dr.CurtLaFrance (USA) discussed possible, probable and definitive diagnostic criteria for PNES. He reviewed published paper to revile most reliable criteria (diagnostic and clinical tolls). Prof.Markus Reuber (UK) talked about biopsychosocial model of PNES. In this way he presented data showing psychological, biological and social aspects of PNES. Adverse early experience, unhelpful attachment styles, illness perception, emotion processing problems and avoidant coping tendencies were observed in patients with PNES. Also, attachment key relationship and social distress could be seen in PNES population. On the other hand, neuroanatomical and functional abnormalities in the brain were revealed using neuroimiging techniques. All these bring arguments to propose a conceptualized model of PNES. Other speakers highlighted different aspects of PNES – comorbidity, psychiatric diagnoses, PNES in intellectually disabled persons and in children etc. Last speaker (Prof.Mike Kerr, UK) outlined future directions and topic which from his point of view will be relevant in next decade: the role of mental health professional in a team serving patient with PNES.