Neurologist, 7 years’ experience, Kenya

This chapter looks at the experience of a Neurologist who has had the privilege to be trained by internationally renowned specialists in epilepsy and Psychogenic Non-Epileptic Seizures (PNES). The diagnosis and management of PNES became more challenging, however, when the Neurologist moved countries to practice as a general Neurologist in a resource-limited regional tertiary referral center in Kenya. There, Neurology remains a poorly taught topic and “neurophobia” is strife; healthcare professionals therefore seem to label everything that falls and shakes as an epileptic seizure or, annoyingly, “unexplained seizure disorder.” Indeed, PNES in sub-Saharan Africa is not very well described in the published literature, and therefore the Neurologist’s introduction of terms such as PNES, transient loss of consciousness, and convulsive syncope were initially met with disbelief. The Neurologist realized early on that all staff, including the trainee doctors, had to be retrained and reminded of the importance of the clinical history and the witness account to make the diagnosis.