title: Clinical profile of psychogenic non-epileptic seizures in adults: A study of 63 cases.
abstract: OBJECTIVE
  To evaluate clinical profile and short-term outcome of psychogenic non-epileptic seizures (PNES) in Indian adult population.
  
  
  METHODS
  A prospective observational study, conducted at tertiary teaching institute at New Delhi.
  
  
  METHODS
  Sixty-three patients with confirmed PNES were enrolled. The diagnosis was based on witnessing the event during video-electroencephalography (Video-EEG) monitoring. A detailed clinical evaluation was done including evaluation for coexistent anxiety or depressive disorders. Patients were divided into two groups on the basis of excessive or paucity of movements during PNES attacks. Patients were followed-up to 12 months for their PNES frequency.
  
  
  METHODS
  Means and standard deviations were calculated for continuous variables. Chi-square and Students t-test were used to compare categorical and continuous variables respectively.
  
  
  RESULTS
  The mean age at onset of PNES was 25.44 years; with F:M ratio of 9.5:1. Coexistent epilepsy was present in 13 (20.63%) cases. Twenty-two patients (44%) with only PNES (n = 50) had received antiepileptic drugs. Out of 63 patients of PNES 24 (38.1%) had predominant motor phenomenon, whereas 39 (61.9%) had limp attacks. The common features observed were pre-ictal headache, ictal eye closure, jaw clenching, resistant behavior, ictal weeping, ictal vocalization, and unresponsiveness during episodes. Comorbid anxiety and depressive disorders was seen in 62.3% and 90.16% patients, respectively. Short-term (6-12 months) outcome of 45 patients was good (seizure freedom in 46.66% and >50% improvement in 24.44% cases).
  
  
  CONCLUSIONS
  PNES is common, but frequently misdiagnosed and treated as epileptic seizures. A high index of suspicion is required for an early diagnosis. Proper disclosure of diagnosis and management of the psychiatric comorbidities can improve their outcome.
  
  
  CONCLUSIONS
  Limited sample size and change in seizures frequency as the only parameter for the assessment of the outcome are the two major limitations of our study.
authors: Department of Neurology, 5th Floor, Academic Block, G. B. Pant Hospital, JLN Marg, New Delhi, India.
authors: Yogesh
authors: Y
authors: Patidar
authors: Meena
authors: M
authors: Gupta
authors: Geeta A
authors: GA
authors: Khwaja
authors: Debashish
authors: D
authors: Chowdhury
authors: Amit
authors: A
authors: Batra
authors: Abhijit
authors: A
authors: Dasgupta
keywords: Coexistent epilepsy; Psychogenic non-epileptic seizures; video-electroencephalography
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