title: Medical comorbidities in patients with psychogenic nonepileptic spells (PNES) referred for video-EEG monitoring.
abstract: Differentiating between psychogenic nonepileptic spells (PNES) and epileptic seizures without video-EEG monitoring is difficult. The presence of specific medical comorbidities may discriminate the two, helping physicians suspect PNES over epilepsy earlier. A retrospective analysis comparing the medical comorbidities of patients with PNES with those of patients with epilepsy was performed in 280 patients diagnosed with either PNES (N = 158, 74.7% females) or epilepsy (N = 122, 46.7% females) in the Epilepsy Monitoring Unit (EMU) of the University of Pittsburgh Medical Center over a two-year period. Patients with PNES, compared to those with epilepsy, were mostly female, significantly more likely to have a history of abuse, had more functional somatic syndromes (fibromyalgia, chronic fatigue syndrome, chronic pain syndrome, tension headaches, and irritable bowel syndrome), and had more medical illnesses that are chronic with intermittent attacks (migraines, asthma, and GERD). The presence of at least of one these disorders may lead physicians to suspect PNES over epilepsy and expedite appropriate referral for video-EEG monitoring for diagnosis.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Ronak
authors.initials: R
authors.lastname: Dixit
authors.forename: Alexandra
authors.initials: A
authors.lastname: Popescu
authors.forename: Anto
authors.initials: A
authors.lastname: Bagić
authors.forename: Gena
authors.initials: G
authors.lastname: Ghearing
authors.forename: Rick
authors.initials: R
authors.lastname: Hendrickson
mesh_terms: D000328:Adult; D003291:Conversion Disorder / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008991:Monitoring, Physiologic; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000453:epidemiology; D012372:ROC Curve; D012189:Retrospective Studies; D012737:Sex Factors; D014741:Video Recording; D055815:Young Adult