Psychiatric diagnoses of patients with psychogenic non-epileptic seizures.
OBJECTIVE
Our purpose was to present and discuss the psychiatric diagnoses of patients who presented psychogenic non-epileptic seizures (PNES) during video-electroencephalographic monitoring (VEEG).


METHODS
Out of 98 patients, a total of 28 patients presented PNES during the diagnostic procedure. In those cases in which the PNES that occurred during VEEG were validated by clinical history (clinical validation), and by showing the recorded event on video to an observer close to the patient (observer validation), was defined psychogenic non-epileptic seizure disorder (PNESD). Psychiatric diagnoses were made according to DSM-IV.


RESULTS
In 27, psychogenic non-epileptic seizures disorder was diagnosed. Fourteen patients presented only with psychogenic non-epileptic seizure disorder, 13 with both psychogenic non-epileptic seizures disorder and epilepsy, and one patient with epilepsy only. Psychiatric diagnoses were: 17 (63%) patients with conversion disorder, five (19%) with somatization disorder, two (7%) with dissociative disorder NOS, two (7%) with post-traumatic stress disorder and one (4%) with undifferentiated somatoform disorder.


CONCLUSIONS
Dissociative-conversion non-epileptic seizures are the most frequent finding, representing the pseudoneurological manifestation of mental disorders that have these symptoms as a common feature. Provisionally, they may be defined as dissociative-conversion non-epileptic seizure disorders.
Marchetti
Renato Luiz
RL
Projeto de Epilepsia e Psiquiatria, Instituto e Departamento de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil. rlmarche@dialdata.com.br
Kurcgant
Daniela
D
Neto
José Gallucci
JG
von Bismark
Mary Ann
MA
Marchetti
Liliana Beccaro
LB
Fiore
Lia Arno
LA
D000328:Adult; D003291:Conversion Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004213:Dissociative Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D012640:Seizures / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D012720:Severity of Illness Index; D014743:Videotape Recording