I am a therapist with a new client who has psychogenic non-epileptic seizures (pnes). what does the medical field think of this disorder - real medical disorder or psych issue?

Depends: Some open label studies suggest usage of some antidepressants may help reduce pnes events. Difficult to deal with and definitely requires multidisciplinary care.

Real disorder: Psychogenic seizures are as real as any other, but aren't due to abnormal electrical activity in the brain. The person experiencing them is not aware that psychologic conflicts are being translated into physical symptoms (seizures); they aren't intentional. Many people with these seizures are survivors of abuse or trauma. Multidisciplinary care is called for. http://tinyurl.com/yhhnysh.

Real suffering: If you have a client suffering from pnes, reminiscent of old school conversion disorder, challenging them or debating "real" or a "psych issue" is perhaps not the best way to help them. If they are doing physical therapy or taking anti-seizure meds, helping them with any anxiety or physical symptoms, and helping them improve their quality of life can help them recover from their suffering.

Medical personnel should regard this condition as a true disorder. It is a conversion disorder, and requires careful and empathic response and support. Avoid blaming the patient, or making them feel that you believe these symptoms are intentionally constructed. Many of them have had extreme psychological stress in the past, including sexual abuse. Often requires multimodalities