title: Conversation analysis in the differentiation of psychogenic nonepileptic and epileptic seizures in pediatric and adolescent settings.
abstract: The differential diagnosis of epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) is often difficult, especially in pediatric and adolescent settings. Conversation analysis (CA) can be a worthwhile diagnostic tool in adults. The aim of this study was to assess the diagnostic value of CA in Italian children and adolescents. Ten patients (seven females and three males), diagnosed using video-EEG as having either ES or PNES, underwent a video-recorded interview by a physician from outside the center specifically trained for this purpose. An external linguistic rater then examined the video recordings and transcripts using CA. Diagnoses formulated on the basis of interactional and linguistic features of the patients' speech were compared with diagnoses made by seizure experts on the basis of all available clinical information including the video-EEG findings. Conversation analysis diagnoses corresponded to the video-EEG diagnoses in 8 out of 10 cases. In conclusion, while some conversational adaptation is necessary to enable children and adolescents to share their seizure experiences with an adult health professional, this study indicates the differential diagnostic potential of a CA approach in these young people with PNES or epilepsy. Larger samples are obviously needed to confirm these findings.
authors: Department of Surgery and Medicine, School of Medicine and Surgery, University of Milano Bicocca, Italy.
authors: Cesare Maria
authors: CM
authors: Cornaggia
authors: Department of Human Adult and Child Pathology, Unit of Infantile Neuropsychiatry, University of Messina, Italy.
authors: Gabriella
authors: G
authors: Di Rosa
authors: Department of Modern Philology, University of Milan, Italy.
authors: Maria
authors: M
authors: Polita
authors: Department of Neurology, University of Messina, Italy.
authors: Adriana
authors: A
authors: Magaudda
authors: Department of Surgery and Medicine, School of Medicine and Surgery, University of Milano Bicocca, Italy.
authors: Cecilia
authors: C
authors: Perin
authors: Department of Mental Health, ASST Rhodense, Rho, Milan, Italy. Electronic address: mbeghi@asst-rhodense.it.
authors: Massimiliano
authors: M
authors: Beghi
mesh_terms: D000293:Adolescent; D002648:Child; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007558:Italy; D007802:Language; D008297:Male; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000523:psychology; D012640:Seizures / Q000175:diagnosis* / Q000523:psychology; D014705:Verbal Behavior / Q000502:physiology*; D014741:Video Recording
keywords: Adolescents; Children; Conversation analysis; Psychogenic nonepileptic seizures