title: Panic attack symptoms differentiate patients with epilepsy from those with psychogenic nonepileptic spells (PNES).
abstract: Psychogenic nonepileptic spells (PNES) are frequently challenging to differentiate from epileptic seizures. The experience of panic attack symptoms during an event may assist in distinguishing PNES from seizures secondary to epilepsy. A retrospective analysis of 354 patients diagnosed with PNES (N=224) or with epilepsy (N=130) investigated the thirteen Diagnostic and Statistical Manual-IV-Text Revision panic attack criteria endorsed by the two groups. We found a statistically higher mean number of symptoms reported by patients with PNES compared with those with epilepsy. In addition, the majority of the panic attack symptoms including heart palpitations, sweating, shortness of breath, choking feeling, chest discomfort, dizziness/unsteadiness, derealization or depersonalization, fear of dying, paresthesias, and chills or hot flashes were significantly more frequent in those with PNES. As patients with PNES frequently have poor clinical outcomes, treatment addressing the anxiety symptomatology may be beneficial.
authors.affiliation: University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA. Electronic address: hendrx@upmc.edu.
authors.forename: Rick
authors.initials: R
authors.lastname: Hendrickson
authors.affiliation: University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Popescu
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Ronak
authors.initials: R
authors.lastname: Dixit
authors.affiliation: University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA.
authors.forename: Gena
authors.initials: G
authors.lastname: Ghearing
authors.affiliation: University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA.
authors.forename: Anto
authors.initials: A
authors.lastname: Bagic
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000175:diagnosis* / Q000523:psychology*; D057285:Precision Medicine; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anxiety; Epilepsy; Panic attack; Psychogenic nonepileptic spells; Psychogenic seizures