PSYCHOGENIC NON-EPILEPTIC SEIZURES AND BORDERLINE PERSONALITY DISORDER IN AN ADOLESCENT GIRL

Psychogenic Non-epileptic Seizures (PNES) are paroxysmal and involuntary episodes of sudden/temporary behavioral changes, with impairment of motor, autonomic, cognitive and emotional functions. Of the patients diagnosed, some resolve quickly, but in the majority of cases, the symptoms persist for months or years. The persistence of PNES may be associated with another underlying pathology, mainly a Personality Disorder, particularly borderline. The present clinical case report to a 16-year-old female adolescent, referred at the age of 13 to the Child and Adolescent Psychiatry Service (CAPS) after multiple visits to the emergency department due to persistent symptoms of anxiety, sadness, ongoing suicidal ideation, self-injurious behavior and recurrent episodes of falling from her own height. As an intervention, it is worth mentioning follow-up in multiple specialty consultations, without any alterations being detected. The young girl attended CAPS appointments, individual psychotherapy, psychopharmacological and family interventions and multiple hospitalizations in mental health facilities.In carrying out the differential diagnosis, the following diagnostic hypotheses were considered: Functional Neurological Symptom Disorder, Major Depressive Disorder and Borderline Personality Disorder (BPD). As in this case, literature confirms that in many patients with PNES, with severe disability and persistence for months or years, show co-occurrence with BPD. This comorbidity predicts a worse prognosis for PNES. This clinical case illustrates the complexity of the condition, particularly the refractoriness of the functional neurological symptoms and the ineffective response to the multiple interventions. In the future, it would be important to invest in research into other types of therapeutic approaches for these patients.