Video-EEG Study of Psychogenic Nonepileptic Seizures: Differential Characteristics in Patients with and without Epilepsy |
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Authors: | &dagger Francesco Mari,Carlo Di Bonaventura,&Dagger Nicola Vanacore,Jinane Fattouch,Anna Elisabetta Vaudano,Gabriella Egeo,&dagger Alfredo Berardelli,&dagger Mario Manfredi,Massimiliano Prencipe, &dagger Anna Teresa Giallonardo |
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Affiliation: | Department of Neurological Sciences, Policlinico Umberto I, University of Rome "La Sapienza," Rome;;I.R.C.C.S. Neuromed, Pozzilli;;and National Centre of Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy |
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Abstract: | Summary: Purpose: Psychogenic nonepileptic seizures (PNES) are episodes that may resemble epileptic seizures (ES) but are not associated with abnormal electrical discharges in the brain. Video-EEG recording of a typical episode is considered the best diagnostic tool available. PNES are, however, also documented in patients with epilepsy (PNES/ES). The purpose of this study was to assess this comorbid population, focusing on the differences between patients with PNES/ES and patients with PNES alone. Methods: We reviewed 110 PNES episodes, occurring spontaneously or induced by means of suggestion techniques, recorded in our video-EEG laboratory over a period of eight years. We identified two subgroups of patients, consisting of 85 PNES cases and 25 PNES/ES cases, and assessed any differences in their characteristics by reviewing a number of variables (age, sex, clinical features, antiepileptic therapy, age of onset, time to diagnosis, pathological history, and length of follow-up). Results: The comparison between the two subgroups revealed that PNES/ES patients displayed some statistically significant differences when compared with PNES alone patients, i.e., younger age, a higher percentage of spontaneously activated events, a shorter disease duration, a longer time to PNES diagnosis, and a lower percentage lost at follow-up. Conclusions: This study confirms that PNES is a common, though probably underestimated, occurrence in epilepsy services. Our results shed light on some different characteristics between PNES and PNES/ES patients. |
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Keywords: | Psychogenic seizures Pseudo-seizures Epilepsy Video-EEG |
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