Patients with psychogenic nonepileptic seizures (PNESs) or pseudoseizures are known to have psychiatric comorbidities. In the present retrospective analysis, we examined the sociodemographics, clinical characteristics, and psychiatric diagnoses of patients with PNESs. Our aim is to demonstrate the contribution of the consulting psychiatrists to the presumed psychiatric diagnoses of the neurologists. We used data from long-term video EEG monitoring (LVEM) performed at a specialized epilepsy center in Turkey. The study group comprised 67 patients (mean age: 30 years, 75% female) diagnosed with PNESs following LVEM of approximately 5 days' duration. Two hundred thirty-three episodes were recorded. Most of the patients experienced a PNES on the first day. All of the patients were taking antiepileptic drugs (AEDs) at the time of admission; 56.7% were taking antidepressant (AD) drugs. All of the PNES patients were diagnosed with conversion disorder by both the neurologists and the psychiatrists. Most of the PNES patients were using multiple AEDs. Cooperation between neurologists and psychiatrists and ongoing education for both neurologists and psychiatrists about PNES are needed in appropriate diagnosing and management of patients with PNES.
Aim/background: Restless legs syndrome (RLS) is a common neurological movement disorder which is commonly seen in hemodialysis (HD) patients. Insomnia, depression, and anxiety disorders frequently show concurrence. In this study, we aimed to investigate RLS and insomnia prevalence and related factors in HD patients. Subjects and methods: Patients who were under HD treatment and healthy controls with similar mean age, sex ratio, and hypertension and diabetes mellitus frequency were included in this study. Depression, insomnia, and daytime sleepiness assessments were performed by using Beck Depression Inventory, Insomnia Severity Index, and Epworth Sleepiness Scale. The diagnosis of RLS was made using the International RLS Study Group consensus criteria. Results: About 156 HD patients and 35 controls were enrolled. The mean age was 50.6 in the HD group and 49.7 in the control group. Female sex was 43.9% in the HD group and 57.1% in the control group. RLS was significantly more frequent in HD patients compared with controls. The rate of sub-threshold insomnia and insomnia with moderate severity was higher in HD patients. While insomnia severity score and diabetes mellitus were significantly associated with the presence of RLS, depression, RLS, older age, and being under HD treatment were independently associated with insomnia severity. Conclusions: HD patients commonly have RLS and insomnia. Insomnia and diabetes mellitus seem to be major factors underlying RLS in HD patients. Furthermore, depression and RLS seem to be closely related to insomnia in these patients. Treatment of depression, insomnia, and RLS may be beneficial to improve quality of life in HD patients.
Generalization of geriatrics education may translate into a better understanding and improved care for older patients. Development of instruments and implementation of qualitative studies to assess attitudes of neurologists toward older adults are needed.
Patients with epilepsy can be considered to be at high risk for developing psychotic disorders. Furthermore, there is association between seizure freedom or the disappearance of the interictal epileptiform events from the EEG record and the occurrence of psychotic symptoms. Also, several newer antiepileptic drugs have been reported to induce psychotic symptoms. We present a patient with epilepsy who developed psychotic symptoms under the treatment of valproic acid (VPA) and lamotrigine (LTG) combination. The mechanism underlying the association between LTG, seizure control and development of psychosis are discussed in the light of the literature.
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