Traumatic events and posttraumatic stress disorder in patients with psychogenic nonepileptic seizures: a critical review.
Although video-EEG monitoring has revolutionized the diagnosis of psychogenic nonepileptic seizure (PNES), the etiology of this condition remains poorly understood. This article is a critical review of studies on the prevalence of traumatic events, abuse, and/or posttraumatic stress disorder (PTSD) in patients with PNES. Searches carried out on MEDLINE (1966-2004) and Web of Science (1945-2004) identified 17 relevant studies. PNES samples showed very high rates of trauma (44-100%) and abuse (23-77%), which were 15-40% higher than those found in control groups. This suggests that traumatic experiences may be a potential risk factor for PNES. PNES samples also showed a higher prevalence of PTSD than control groups, raising the possibility that PNES may arise as a clinical expression of a hypothetical PTSD subtype the core symptoms of which are dissociative. Methodological limitations do not permit the confirmation of these hypotheses. Stronger research designs are needed, such as prospective and case-control studies in both hospital and community settings.
Fiszman
Adriana
A
Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. adrianafiszman@terra.com.br
Alves-Leon
Soniza Vieira
SV
Nunes
Renata Gomes
RG
D'Andrea
Isabella
I
Figueira
Ivan
I
D000328:Adult; D004569:Electroencephalography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008016:Life Change Events; D016239:MEDLINE / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011602:Psychophysiologic Disorders / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D012640:Seizures / Q000150:complications* / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000453:epidemiology