title: Newly presenting psychogenic nonepileptic seizures: incidence, population characteristics, and early outcome from a prospective audit of a first seizure clinic.
abstract: There are few published population-based data for psychogenic nonepileptic seizures (PNES). We prospectively identified first presentations of PNES from a population of 367,566, over 3 years. PNES were diagnosed in 68 patients, in 54 of whom the diagnosis was confirmed by video/EEG recording, indicating an incidence of 4.90/100,000/year. Median diagnostic delay was 0.6 ± 0.2 year. At presentation with PNES, our patients already had high rates of psychological morbidity, medically unexplained symptoms other than PNES, and economic dependence. At 3 months postdiagnosis, 27 of 54 patients (50.0%) were spell free. For 24 of the 27 patients (88.9%), spells ceased immediately on communication of the diagnosis. At 6 months, 24 of 54 patients (44.4%) were spell free. Poor early outcome was predicted by unemployment. Our data suggest that early outcome is good in patients with recent-onset PNES, but some patients relapse quickly.
authors.affiliation: Department of Neurology, Southern General Hospital, Glasgow G51 4TF, Scotland. r.duncan@clinmed.gla.ac.uk
authors.forename: Roderick
authors.initials: R
authors.lastname: Duncan
authors.forename: Saif
authors.initials: S
authors.lastname: Razvi
authors.forename: Sharon
authors.initials: S
authors.lastname: Mulhern
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013997:Time Factors; D014741:Video Recording / Q000379:methods; D055815:Young Adult