Video-EEG study of psychogenic nonepileptic seizures: differential characteristics in patients with and without epilepsy.
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.
Mari
Francesco
F
Department of Neurological Sciences, Policlinico Umberto I, University of Rome, La Sapienza, Rome.
Di Bonaventura
Carlo
C
Vanacore
Nicola
N
Fattouch
Jinane
J
Vaudano
Anna Elisabetta
AE
Egeo
Gabriella
G
Berardelli
Alfredo
A
Manfredi
Mario
M
Prencipe
Massimiliano
M
Giallonardo
Anna Teresa
AT
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