A spell in the epilepsy clinic and a history of "chronic pain" or "fibromyalgia" independently predict a diagnosis of psychogenic seizures.
The clinical suspicion for psychogenic nonepileptic seizures (PNES) is based on multiple features obtained in the history. We reviewed the records of all patients evaluated over 5 years in a single epilepsy clinic for refractory seizures who eventually underwent EEG/video monitoring. We designated two groups: (1) patients with a diagnosis of "fibromyalgia" or "chronic pain" and (2) patients who had a seizure during the visit, either in the waiting area or in the examining room. Of 36 patients with "fibromyalgia" or "chronic pain," 27 (75%) were found to have PNES. Of 13 patients who had a "seizure" during their clinic visit, 10 (75%) were found to have PNES. We conclude that each of these findings has a predictive value of 75%.
Benbadis
Selim R
SR
Comprehensive Epilepsy Program, University of South Florida and Tampa General Hospital, Tampa, FL, USA. sbenbadi@hsc.usf.edu
D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods; D005356:Fibromyalgia / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008487:Medical History Taking; D010146:Pain / Q000175:diagnosis* / Q000503:physiopathology; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000523:psychology; D012640:Seizures / Q000175:diagnosis* / Q000523:psychology*; D014741:Video Recording