Management of patients with nonepileptic attack disorder in the United Kingdom: a survey of health care professionals.

Nonepileptic attack disorder (NEAD) is one of the commonest differential diagnoses of epilepsy. A number of approaches to the communication of this diagnosis and its treatment have been described; however, there are currently no evidence-based management pathways. This study captures the care currently received by patients with NEAD in the United Kingdom and Ireland. The findings are based on 130 responses to an Internet survey of clinicians from the United Kingdom and the Republic of Ireland (65.6% neurologists). The responses indicate that there is much variability in the approaches to diagnosis of NEAS and communication of the diagnosis to the patient. Although there is good access to diagnostic equipment, 30% of diagnoses are made on clinical grounds alone. While 93% of respondents endorsed psychological treatment as the treatment of choice, only 35% were able to refer all of their patients for this treatment and 15% were unable to refer any patients.