Author details

In 2003, we had not video-EEG facilities and then a procedure to provoke and to distinguish PNES from ES in our setting is introduced. At that time, we got IRB number, an approval by the Ethical Advisory Board (A0;012-2000) and written informed consent from selected patients. However, today, we have no doubt that it was a nonethical procedure, and in spite of that we

Confirming a PNES diagnosis and disclosure this information to the child, parents and other interested people build up a special challenge related to the values of justice professionalism, human resource utilization, and trust for health care providers in relation to patients, families, and other colleagues. The preservation of an adequate therapeutic relationship plays strongly in the values at stake. Most of neurologists felt confident about discontinuing the medical treatment when diagnosis of PNES is confirmed, but ethical dilemma arises when the prescribing clinician faces is discontinuing AEDs in a timely manner without losing the trust and confidence of the patient and/or the patient's relatives. Sometimes some patients and relatives

Elements often taken into account during ethical dilemmas include the patient and family's treatment preferences, developmental stage, psychosocial background, quality of life, applicable laws, institutional policies, professional duties, and other practical stakeholder obligations and responsibilities. Even the most skilled attending doctor struggles with ethical dilemmas that arise during diagnosis and management of PNES patients. These relationships coupled with the uncertainty and stigma surrounding PNES result in complex dilemmas for treating clinicians. Significant mental health, social, and community resources are frequently necessary to effectively treat this patient population, but these resources are scarce. To ensure a successful management of PNES, all ethical values should be taken in to consideration from the first

We would like to thanks to Prof. Olivier Wenker, CEO of Internet Journal of Publications to granted permission for including in this chapter some figures and tables published online by

Parts of this chapter are taken from the authors' former work. In this regards we also want to

One of the article was published by IJN and co-authored by Prof. H Foyaca who is also an Editor-in-Chief of the IJN. The other two sources were properly cited in the body of this

chapter and the reference list. We also declare that we have not conflict of interest.

did not afford any problem, we deeply regret about that procedure.

decide to seek for a second medical opinion and we have to respect that.

clinic [122–126].

124 Seizures

Acknowledgements

2. Cole et al. [123].

3. Benbadis [49].

the before-mentioned editorial house.

acknowledge to following sources:

1. Foyaca-Sibat and Ibañez-Valdés [13].

Lourdes de Fátima Ibañez-Valdés\* and Humberto Foyaca-Sibat

\*Address all correspondence to: lourdesfibanezvaldes@gmail.com

Department of Neurology, Nelson Mandela Academic Central Hospital, Walter Sisulu University, Mthatha, South Africa
