Clinical differences between patients with nonepileptic seizures who report antecedent sexual abuse and those who do not.
OBJECTIVE
To investigate clinical differences between patients with psychogenic nonepileptic seizures (PNES) who report antecedent sexual abuse, and patients who do not.


METHODS
In a consecutive series of 176 patients with video-EEG confirmed PNES without epilepsy, we compared patients who reported antecedent sexual abuse with those who did not report sexual abuse, in respect of a range of demographic and clinical variables.


RESULTS
Fifty-nine women (45%) and 5 men (11%) reported sexual abuse. Those reporting sexual abuse had earlier onset PNES (28.5 vs. 33.1 years, p = 0.0319) and greater delay from onset to diagnosis (median 5.2 vs. 3.2 years, p < 0.0137). They more often drew social security benefits (p = 0.0054) and were less often in cohabiting relationships (p = 0.0006). Those who reported sexual abuse had poorer mental health on a range of indicators. Their spells were more often "convulsive" (p = 0.0419), were more severe (p = 0.0011), were more likely to have emotional triggers (p = 0.0045) and to include prodromes (p = 0.0424) and flashbacks (p < 0.0001). A history of nocturnal spells (p = 0.0109), injury during spells (p = 0.0056), and incontinence during spells (p = 0.0083) were also more common in the patients reporting sexual abuse.


CONCLUSIONS
Our results suggest that patients with PNES who report sexual abuse have more severe PNES, are more likely to have PNES with features that suggest epilepsy, and are psychiatrically more unwell than those who do not report sexual abuse.
Selkirk
Mhairi
M
Department of Neurology, West of Scotland Regional Epilepsy Service, Institute of Neurological Sciences, Southern General Hospital, Glasgow, Scotland.
Duncan
Roderick
R
Oto
Meritxell
M
Pelosi
Anthony
A
D000328:Adult; D017668:Age of Onset; D003710:Demography; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004829:Epilepsy, Generalized / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D016728:Self-Injurious Behavior / Q000453:epidemiology; D012720:Severity of Illness Index; D012742:Sex Offenses / Q000523:psychology* / Q000706:statistics & numerical data*; D013997:Time Factors; D014743:Videotape Recording