title: Risk Factors for Diagnostic Delay in Psychogenic Nonepileptic Seizures Among Children and Adolescents.
abstract: This study aims to analyze a series of pediatric patients with psychogenic nonepileptic seizures (PNES) to establish the diagnostic gap and possible risk factors for the delayed diagnosis in this age group.
  
  
  
  We evaluated all children with PNES documented by video electroencephalography. None had a previous diagnosis of PNES. In total, we included 53 children (interquartile range: seven to 17 years; mean age 12.81 years [S.D. 3.15]; 60.4% girls) who underwent a protocol consisting of neurological and psychiatric interviews.
  
  
  
  The average time between seizure onset and referral was 17.76 months (interquartile range: 0.5 to 48 months; S.D. ± 12.62). Earlier age of onset correlated with a later diagnosis (P < 0.001). The late referral group also presented with a history of psychological abuse (P = 0.018).
  
  
  
  Youth with PNES represent a diagnostic challenge. Identification of children at risk might lead to earlier diagnosis of PNES.
authors.affiliation: Laboratory of Clinical Neurophysiology, Institute of Psychiatry, University of São Paulo Medical School (IPq-HC-FMUSP), São Paulo, SP, Brazil; LIM 21-Laboratory of Neuroimaging in Neuropsychiatric Disorders, Institute and Department of Psychiatry, University of São Paulo, São Paulo, SP, Brazil; NAPNA-Research Support Center of the University of Sao Paulo on Applied Neuroscience, University of São Paulo, São Paulo, SP, Brazil. Electronic address: kettevalente@msn.com.
authors.forename: Kette D
authors.initials: KD
authors.lastname: Valente
authors.affiliation: Laboratory of Clinical Neurophysiology, Institute of Psychiatry, University of São Paulo Medical School (IPq-HC-FMUSP), São Paulo, SP, Brazil.
authors.forename: Ruda
authors.initials: R
authors.lastname: Alessi
authors.affiliation: Laboratory of Clinical Neurophysiology, Institute of Psychiatry, University of São Paulo Medical School (IPq-HC-FMUSP), São Paulo, SP, Brazil.
authors.forename: Silvia
authors.initials: S
authors.lastname: Vincentiis
authors.affiliation: Nursing School of the University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Bernardo Dos
authors.initials: BD
authors.lastname: Santos
authors.affiliation: Laboratory of Clinical Neurophysiology, Institute of Psychiatry, University of São Paulo Medical School (IPq-HC-FMUSP), São Paulo, SP, Brazil; LIM 21-Laboratory of Neuroimaging in Neuropsychiatric Disorders, Institute and Department of Psychiatry, University of São Paulo, São Paulo, SP, Brazil; NAPNA-Research Support Center of the University of Sao Paulo on Applied Neuroscience, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Patricia
authors.initials: P
authors.lastname: Rzezak
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002649:Child Abuse / Q000523:psychology; D057210:Delayed Diagnosis; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016014:Linear Models; D008297:Male; D009460:Neurologic Examination; D012017:Referral and Consultation; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis* / Q000453:epidemiology*; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D013997:Time Factors; D014741:Video Recording
keywords: adolescents; children; diagnosis; nonepileptic seizures; psychogenic