As crises não epilépticas funcionais como expressão clínica do transtorno de estresse pós-traumático complexo

Abstract

Hysteria, situated at the delicate intersection between psyche and soma, remains a relevant phenomenon in understanding psychosomatic manifestations. Historically linked to the concept of hysteria, Functional Non-Epileptic Seizures (FNES) are a subtype of functional neurological disorder characterized by events resembling seizures but not associated with the electrophysiological abnormalities of epilepsy. This disorder illustrates the interplay between complex trauma and physical manifestations. This study examined the relationship between FNES and Complex Post-Traumatic Stress Disorder (C-PTSD), emphasizing the central role of complex trauma in the pathogenesis of these conditions. The growing understanding of FNES is closely tied to research on complex trauma, particularly the pioneering work of Judith Herman on C-PTSD. Herman's perspective highlights the profound psychological effects caused by prolonged and repeated exposure to interpersonal trauma, including alterations in affect regulation, self-perception, and patterns of interpersonal relationships. These changes align with the diagnostic criteria recently proposed by the ICD-11 for C-PTSD. The inclusion of C-PTSD as a distinct diagnostic entity in the ICD-11 marks a milestone for psychotraumatology. This recognition reflects a deeper understanding among researchers of the debilitating impacts of complex trauma, which manifest in both psychological and physical symptoms. Conceptual differences between diagnostic systems have been noted, particularly regarding the classification of conversion and dissociative symptoms. While the ICD-11 categorizes these symptoms as part of dissociative disorders, the DSM-5 treats them as distinct categories. These divergences underscore the need for further studies, given their significance for diagnosis, treatment, and patient quality of life.