Eur Child Adolesc Psychiatry (2017) 26:1207–1217 DOI 10.1007/s00787-017-0976-0
ORIGINAL CONTRIBUTION
The respiratory control of carbon dioxide in children and adolescents referred for treatment of psychogenic non‑epileptic seizures Kasia Kozlowska1,2,3 · Reena Rampersad1,3 · Catherine Cruz1 · Ubaid Shah1,3,4 · Catherine Chudleigh1,3 · Samantha Soe1,3 · Deepak Gill1,3 · Stephen Scher3,5,6 · Pascal Carrive7
Received: 12 January 2017 / Accepted: 6 March 2017 / Published online: 24 March 2017 © The Author(s) 2017. This article is an open access publication
Abstract Psychogenic non-epileptic seizures (PNES) are a common problem in paediatric neurology and psychiatry that can best be understood as atypical responses to threat. Threats activate the body for action by mediating increases in arousal, respiration, and motor readiness. In previous studies, a range of cardiac, endocrine, brain-based, attention-bias, and behavioral measures have been used to demonstrate increases in arousal, vigilance, and motor readiness in patients with PNES. The current study uses respiratory measures to assess both the motor readiness of the respiratory system and the respiratory regulation of CO2. Baseline respiratory rates during clinical assessment and arterial CO2 levels during the hyperventilation component of routine video electroencephalogram were documented in 60
Electronic supplementary material The online version of this article (doi:10.1007/s00787-017-0976-0) contains supplementary material, which is available to authorized users. * Kasia Kozlowska [email protected]; [email protected]
children and adolescents referred for treatment of PNES and in 50 controls. Patients showed elevated baseline respiratory rates [t(78) = 3.34, p = .001], with 36/52 (69%) of patients [vs. 11/28 (39%) controls] falling above the 75th percentile (χ2 = 6.7343; df = 1; p = .009). Twentyeight (47%) of patients [vs. 4/50 (8%) controls] showed a skewed hyperventilation-challenge profile—baseline PCO2
ORIGINAL CONTRIBUTION
The respiratory control of carbon dioxide in children and adolescents referred for treatment of psychogenic non‑epileptic seizures Kasia Kozlowska1,2,3 · Reena Rampersad1,3 · Catherine Cruz1 · Ubaid Shah1,3,4 · Catherine Chudleigh1,3 · Samantha Soe1,3 · Deepak Gill1,3 · Stephen Scher3,5,6 · Pascal Carrive7
Received: 12 January 2017 / Accepted: 6 March 2017 / Published online: 24 March 2017 © The Author(s) 2017. This article is an open access publication
Abstract Psychogenic non-epileptic seizures (PNES) are a common problem in paediatric neurology and psychiatry that can best be understood as atypical responses to threat. Threats activate the body for action by mediating increases in arousal, respiration, and motor readiness. In previous studies, a range of cardiac, endocrine, brain-based, attention-bias, and behavioral measures have been used to demonstrate increases in arousal, vigilance, and motor readiness in patients with PNES. The current study uses respiratory measures to assess both the motor readiness of the respiratory system and the respiratory regulation of CO2. Baseline respiratory rates during clinical assessment and arterial CO2 levels during the hyperventilation component of routine video electroencephalogram were documented in 60
Electronic supplementary material The online version of this article (doi:10.1007/s00787-017-0976-0) contains supplementary material, which is available to authorized users. * Kasia Kozlowska [email protected]; [email protected]
children and adolescents referred for treatment of PNES and in 50 controls. Patients showed elevated baseline respiratory rates [t(78) = 3.34, p = .001], with 36/52 (69%) of patients [vs. 11/28 (39%) controls] falling above the 75th percentile (χ2 = 6.7343; df = 1; p = .009). Twentyeight (47%) of patients [vs. 4/50 (8%) controls] showed a skewed hyperventilation-challenge profile—baseline PCO2
