title: Video-EEG study of psychogenic nonepileptic seizures: differential characteristics in patients with and without epilepsy.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neurological Sciences, Policlinico Umberto I, University of Rome, La Sapienza, Rome.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mari
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Bonaventura
authors.forename: Nicola
authors.initials: N
authors.lastname: Vanacore
authors.forename: Jinane
authors.initials: J
authors.lastname: Fattouch
authors.forename: Anna Elisabetta
authors.initials: AE
authors.lastname: Vaudano
authors.forename: Gabriella
authors.initials: G
authors.lastname: Egeo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berardelli
authors.forename: Mario
authors.initials: M
authors.lastname: Manfredi
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Prencipe
authors.forename: Anna Teresa
authors.initials: AT
authors.lastname: Giallonardo
mesh_terms: D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D003291:Conversion Disorder / Q000175:diagnosis / Q000453:epidemiology; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000453:epidemiology; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology; D013404:Suggestion; D014743:Videotape Recording