title: Co-morbidities and outcome of childhood psychogenic non-epileptic seizures--an observational study.
abstract: OBJECTIVE
  To assess the psychiatric diagnoses and outcome in children with psychogenic non-epileptic seizures (PNES).
  
  
  METHODS
  This hospital based observational study was performed on 44 children aged <16 years, who suspected to have psychogenic non-epileptic seizures based on video-EEG, from August 2005 to August 2012. The parameters noted were the psychiatric diagnosis, co-morbidities, management assessment and interventions (pharmacological and psychosocial), number and duration of follow-up visits, symptoms at follow-up, functioning as reflected by involvement in the social and scholastic work.
  
  
  RESULTS
  All forty four children completed the evaluation. Thirty four children were diagnosed as having PNES and the underlying psychiatric diagnosis was conversion disorder (n=34, 77.3%). Co-morbid psychiatric disorders were present in 17 children (50%). The common co-morbidities were intellectual disability (n=8, 23.5%), specific learning disorder (n=5, 14.7%), and depression (n=5, 14.7%). Co-morbid epilepsy was present in 8 (23.5%) children and family history of epilepsy was present in 10 (29.4%) cases. About 17 of 34 (50.0%) patients had a minimum follow-up of 6 months (13.9 ± 4.8 months). Twenty six children (76.5%) remained symptom free at the follow-up of 9.8 ± 7 months. The remaining 10 children (22.7%) had non-epileptic seizures with underlying diagnosis of Attention Deficit Hyperactivity Disorder (ADHD), gratification disorder and other physiological conditions.
  
  
  CONCLUSIONS
  Conversion disorder is a common diagnosis underlying psychogenic non-epileptic seizures. Outcome was good in 76.5% children with PNES. A multidisciplinary approach is needed in the diagnosis and management of PNES.
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Vikram Singh
authors.initials: VS
authors.lastname: Rawat
authors.affiliation: Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India; Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Dhiman
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Electronic address: sanjib_sinha2004@yahoo.co.in.
authors.forename: Sanjib
authors.initials: S
authors.lastname: Sinha
authors.affiliation: Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Kommu John
authors.initials: KJ
authors.lastname: Vijay Sagar
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Harish
authors.initials: H
authors.lastname: Thippeswamy
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Santosh Kumar
authors.initials: SK
authors.lastname: Chaturvedi
authors.affiliation: Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Shoba
authors.initials: S
authors.lastname: Srinath
authors.affiliation: Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
authors.forename: Parthasarthy
authors.initials: P
authors.lastname: Satishchandra
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D016896:Treatment Outcome; D014741:Video Recording
chemical_list: D000927:Anticonvulsants
keywords: Non-epileptic; Outcome assessment seizures; Pediatric; Psychogenic