Childhood paroxysmal nonepileptic events

Yılmaz, Ünsal; Serdaroğlu, Ayşe; Gürkaş, Esra; Hırfanoğlu, Tuğba; Cansu, Ali

doi:10.1016/j.yebeh.2012.12.028

Cited by 14 publications

(18 citation statements)

References 24 publications

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“…[ 1 ] 10%–43% of patients monitored in video-electroencephalogram (VEEG) laboratories in literature have nonepileptic events. [ 2 3 4 5 6 7 8 9 10 11 12 13 ] Misdiagnosis is fraught with dire consequences such as unnecessary investigations, potentially harmful treatments, unwarranted restriction of activities, and parental over-anxiety. All these lead to serious psychosocial and financial burden on the family and society.…”

Section: Introductionmentioning

confidence: 99%

“…The differential diagnosis is broader in children than adults. [ 2 3 4 5 6 7 8 9 10 11 12 13 ] Majority of PNEs in adults are psychogenic while in children physiological as well as psychogenic events are seen, some being age specific. Physiologic events include sleep-related disorders (sleep myoclonus, parasomnias), shuddering attacks, breath-holding spells, and vasovagal syncope.…”

Section: Introductionmentioning

confidence: 99%

“…VEEG is the gold standard for confirmation though high cost, availability and expert interpretation limits its use. [ 3 4 5 6 7 8 9 10 11 12 13 ] Correct diagnosis leads to successful management, that is, discontinuing AEDs, commencing new treatment (movement disorders, migraine) and further referrals(cardiologist, psychiatrist). [ 5 6 7 8 9 ] This ultimately saves on health resources and alleviates significant distress in affected families.…”

Section: Introductionmentioning

confidence: 99%

“…[ 16 17 ] Most studies reported in the literature are retrospective analysis of VEEG units which has limitations. [ 3 4 5 6 7 8 9 10 11 12 13 ] Mild, infrequent, and straightforward cases are not advised VEEG. Retrospective studies are constrained by information from the medical records and recall of individuals.…”

Section: Introductionmentioning

confidence: 99%

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Paroxysmal nonepileptic events in a pediatric epilepsy clinic

et al. 2021

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A BSTRACT Aims: We aimed to study the frequency, age, and gender distribution of paroxysmal nonepileptic events (PNEs) in children referred to epilepsy clinic with the diagnosis of epilepsy. We also evaluated the therapeutic implications of correct diagnosis and co-existence of true epilepsy in this population. Settings and Design: All new patients below 18 years attending the Pediatric epilepsy out-patient clinic of PD Hinduja hospital over 6 months were evaluated. Materials and Methods: Patients with history of paroxysmal events characterized by abrupt changes in consciousness or behavior or movement were included. They were assessed on description of events aided by recorded videos. If the diagnosis was not confirmed by this preliminary evaluation, further investigations were advised. Statistical Analysis Used: Chi-square/Fisher’s exact test was used to analyze differences between categorical variables and Kruskal–Wallis test between continuous variables. The data were analyzed by SAS University Edition. All significance tests were two-tailed with α <0.05. Results: Two hundred new patients presenting with paroxysmal events were enrolled over 6 months. After diagnoses, 19% of these children had PNEs, 80% had epileptic events, and 1% remained undiagnosed. Common nonepileptic events seen were physiological in patients below 5 years and psychogenic in older children. Thirty-four percent of patients with PNEs were on anti-epileptic drugs (AEDs). After confirming nonepileptic attacks, only 2.6% patients needed AEDs for coexisting epilepsy which was statistically significant ( P < 0.001) change in treatment. Conclusions: Epilepsy mimics are common in children and are often misdiagnosed causing undue stress. Correct diagnosis leads to a drastic change in management like withdrawal of drugs, commencing new treatment if needed, and appropriate referrals.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Paroxysmal nonepileptic events in a pediatric epilepsy clinic

et al. 2021

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“…Although epilepsy is often thought of first, non-epileptic attacks are very frequent in children and adolescents [1]. Non-epileptic attacks comprise a wide spectrum of disorders, including paroxysmal movement disorders, functional (psychogenic) attacks, Sandifer syndrome, cardiac events and behavioral events.…”

Section: Introductionmentioning

confidence: 99%

Clinical Pearls - how my patients taught me: The fainting lark symptom

et al. 2016

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BackgroundCompulsive movements, complex tics and stereotypies are frequent, especially among patients with autism or psychomotor retardation. These movements can be difficult to characterize and can mimic other conditions like epileptic seizures or paroxysmal dystonia, particularly when abnormal breathing and cerebral hypoxia are induced.Case presentationWe describe an 18-year-old patient with Asperger syndrome who presented with attacks of tonic posturing of the trunk and neck. The attacks consisted of self-induced stereotypic stretching of the neck combined with a compulsive Valsalva-like maneuver. This induced cerebral hypoperfusion and subsequently dysautonomia and some involuntary movements of the arms.ConclusionThis patient suffered from a complex tic with compulsive respiratory stereotypies. His symptoms contain aspects of a phenomenon described in early literature as ‘the fainting lark’.Electronic supplementary materialThe online version of this article (doi:10.1186/s40734-016-0045-8) contains supplementary material, which is available to authorized users.

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The assessment of the knowledge and practices of healthcare providers regarding paroxysmal non‐epileptic events (PNES) in children: A cross‐sectional study

Gündüz,

Tubas

et al. 2023

Epileptic Disorders

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ObjectiveParoxysmal non‐epileptic events (PNEs) are a group of disorders that may be misdiagnosed as epilepsy. This study has aimed to assess the knowledge and practices of family physicians and pediatricians regarding the diagnosis, treatment, and follow‐up of PNEs in children.MethodsThe study was designed as a prospective cross‐sectional study that was conducted between March 1, 2022, and June 1, 2022, by reaching pediatric specialists and assistants, family physicians, subspecialty assistants, and subspecialists using a Google questionnaire. The survey consists of 26 questions. The questionnaire used by the researchers was prepared in accordance with the literature search and it included detailed questions on the diagnosis, treatment, and differential diagnosis of PNEs.ResultsA total of 37.3% worked as specialists. Most of the participants (41.3%) have worked in training and research hospitals, and 44.3% have been physicians for 6–10 years. The mean and standard deviation for the total score were 10.1 ± 2.6. The scores of family physicians were statistically lower than those of specialists, subspecialty assistants, and subspecialists. A total of 67.2% left the decision of whether the patient should stop taking their medication to another clinician. 45% of the doctors said that they were uncomfortable with the diagnosis.SignificanceThe study findings emphasized the significant knowledge gap among healthcare providers regarding PNEs in children, highlighting the need for targeted educational interventions to improve their understanding and diagnostic skills in this area.

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Childhood paroxysmal nonepileptic events

Cited by 14 publications

References 24 publications

Paroxysmal nonepileptic events in a pediatric epilepsy clinic

Paroxysmal nonepileptic events in a pediatric epilepsy clinic

Clinical Pearls - how my patients taught me: The fainting lark symptom

The assessment of the knowledge and practices of healthcare providers regarding paroxysmal non‐epileptic events (PNES) in children: A cross‐sectional study

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