Clinical characteristics and outcome of patients diagnosed with psychogenic nonepileptic seizures: A 5-year review

O’Sullivan, Sean S.; Spillane, Jennifer; McMahon, Elaine M.; Sweeney, Brian; Galvin, Roderick J.; McNamara, Brian; Cassidy, Eugene

doi:10.1016/j.yebeh.2007.04.003

Cited by 84 publications

(67 citation statements)

References 34 publications

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“…The rate of 20% employment in our study is similar to the low employment rate reported in other studies ranging between 20% -40% [23]. Similarly, the present finding that 55% to 75% of our patients were on disability benefits, is in agreement with prior reports [24] [25]. However, we also found a trend of lower employment rate and higher percentage of benefits received in AAMs.…”

Section: Discussionsupporting

confidence: 92%

Psychogenic Nonepileptic Seizures in Men: Comparison of Clinical and Psychosocial Features between Afro-American and Caucasian Patients

Abubakr¹,

Wambacq²

2014

JBBS

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PNES represents an alternative diagnosis for refractory epilepsy in the EMU, however it is less frequent in males. The impact of ethnicity on PNES was evaluated retrospectively in 54 males with confirmed diagnosis of PNES. We evaluated and compared the demographic, clinical and psychosocial characteristics of both AAMs and WMs. In both AAMs and CMS, over half of all patients were <50 years of age, had a shorter history of spells, and took between 1 to 3 AEDS. However, the spells were more frequent in AAM (2.25) compared to CM, but the CMs had more frequent limp/unresponsive events. Also there was higher incidence of head injury report, alcohol and substance abuse, unemployment and disability benefits in AAMs compared to CMs. These differences may provide insight into the causative factors in PNES.

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Section: Discussionsupporting

confidence: 92%

Psychogenic Nonepileptic Seizures in Men: Comparison of Clinical and Psychosocial Features between Afro-American and Caucasian Patients

Abubakr¹,

Wambacq²

2014

JBBS

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“…12,13 PNES are more common among female patients, that correspond to up to 80% of the cases, 14 although higher frequency of male patients has recently been reported. 15 This condition affects predominantly young patients, with a high incidence between the ages 15 to 35 years (~80%). Misdiagnosis and mistreatment of PNES are associated with high utilization of services and high costs.…”

Section: Psychiatric Disorders In Epilepsymentioning

confidence: 99%

Anxiety and mood disorders in psychogenic nonepileptic seizures

Filho¹,

Caboclo²

2007

J. epilepsy clin. neurophysiol.

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The diagnosis of psychogenic nonepileptic seizures (PNES), particularly in patients with epilepsy, poses a special challenge to the physician in care of these patients. Psychiatric disorders (PD) are more common among patients with epilepsy than in the general population, and this appears to be even more important in patients with PNES. Depression and other mood disorders, as well as anxiety disorders -particularly panic attacks -may make the management of these patients even more difficult in the clinical practice. Concomitant psychiatric conditions have been associated with a poor outcome in patients with PNES]. Psychiatric and psychological intervention has been shown to be associated with improved outcome in PNES in outcome studies, although data is conflicting in this matter. The intricacies and practical implications of such issues are discussed.Key words: epilepsy, psychogenic nonepileptic seizures, psychiatric disorders, anxiety. RESUMO Ansiedade e desordens de humor em crises não-epilépticas psicogênicasDiagnóstico de crises não-epilépticas psicogênicas (CNEP), particularmente em pacientes com epilepsia, é de modo geral desafiador para os profissionais associados ao cuidado com estes pacientes. As desordens psiquiátricas são mais freqüentes em pacientes com epilepsia quando comparadas à população em geral, sendo ainda mais significativas em pacientes portadores de CNEP. Depressão e desordens de humor, bem como transtorno de ansiedade -particularmente os ataques de pânico -podem imputar dificuldades significativas ao manejo destes pacientes. Comorbidades psiquiátricas têm sido associadas a prognóstico mais reservado em pacientes portadores de CNEP. Intervenções psiquiátricas e psicológicas potencialmente podem melhorar o prognóstico, mas os estudos disponíveis são conflitantes. Detalhes e implicações práticas relacionadas a este cenário são apresentadas e discutidas.Unitermos: epilepsia, crises não-epilépticas psicogênicas, desordens psiquiátricas, ansiedade.

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“…2,3,10 The first clue to the correct diagnosis may be apparent in the history. Although the diagnosis of nonepileptic psychogenic seizures cannot be established by history alone, the suspicion should be raised when a careful history elicits the occurrence of different seizures types or clinical features suggestive of nonepileptic psychogenic seizures, such as side-to-side head movements, asynchronous limb movements, opistotonus, pelvic thrusting, ictal crying or eye closure during the seizure.…”

Section: Diagnosismentioning

confidence: 99%

Epilepsy surgery in patients with coexisting psychogenic nonepileptic seizures: diagnosis and treatment

Castro

2007

J. epilepsy clin. neurophysiol.

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The prevalence of epileptic seizures among patients with psychogenic nonepileptic seizures may range from five to fifty percent. Diagnosis of both conditions occurring in association may be difficult and requires both clinical skills and prolonged video-EEG monitoring. Occurrence of seemingly psychogenic events during video-EEG monitoring should be interpreted with caution, and the relative role of both psychogenic and epileptic seizures in day-to-day living should be carefully evaluated for each individual patient. Surgery is not contraindicated in this setting, however patients and family members should be educated about both conditions before surgical decision. Psychogenic seizures and other psychiatric co-morbidities should be properly assessed and treated before surgery. Diagnosis and management of postoperative events (epileptic or psychogenic) is challenging. This difficulty can be minimized by appropriate presurgical management, that includes diagnostic testing, neurologic and psychiatric treatment and patient and family counseling. Key words: epilepsy surgery, psychogenic nonepileptic seizures, pseudoseizures, video-EEG, treatment. RESUMOCrises não-epilépticas e cirurgia na epilepsia: uma revisão A prevalência de crises epilépticas entre pacientes com crises não-epilépticas psicogênicas varia entre cinco e 50%. A diagnóstico desta comorbidade pode ser difícil, e requer experiência clínica, além de monitorização prolongada por vídeo-EEG. A ocorrência de eventos sugestivos de crises não-epilépticas durante a monitorização por vídeo-EEG deve ser interpretada com cautela. O papel relativo de cada uma das comorbidades na vida diária do paciente deve ser avaliada caso a caso. Não há contra-indicação formal para a cirurgia, contudo pacientes e familiares devem ser esclarecidos acerca de ambos os diagnósticos e as crises psicogênicas e outras comorbidades psiquiátricas devem ser diagnosticadas e tratadas adequadamente antes da cirurgia. O diagnóstico e tratamento de eventos epilépticos ou psicogênicos que ocorram após a cirurgia é ainda mais difícil, porém esta dificuldade pode ser minimizada com uma avaliação pré-operatória cuidadosa, que inclui diagnóstico e tratamento neurológico e psiquiátrico precisos, além de aconselhamento a pacientes e familiares. Unitermos: cirurgia de epilepsia, crises não-epilépticas psicogênicas, pseudocrises, vídeo-EEG, tratamento.

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Clinical characteristics and outcome of patients diagnosed with psychogenic nonepileptic seizures: A 5-year review

Cited by 84 publications

References 34 publications

Psychogenic Nonepileptic Seizures in Men: Comparison of Clinical and Psychosocial Features between Afro-American and Caucasian Patients

Psychogenic Nonepileptic Seizures in Men: Comparison of Clinical and Psychosocial Features between Afro-American and Caucasian Patients

Anxiety and mood disorders in psychogenic nonepileptic seizures

Epilepsy surgery in patients with coexisting psychogenic nonepileptic seizures: diagnosis and treatment

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