Clinical characteristics of functional (psychogenic nonepileptic) seizures: An international retrospective study

Asadi‐Pooya, Ali A.; Brigo, Francesco; Mesraoua, Boulenouar; Karakis, Ioannis; Hosny, Hossam; Alsaadi, Taoufik; Gigineishvili, David; Ali, Musab; Janocko, Nicholas J.; Elsheikh, Lubna; Hingray, Coraline

doi:10.1016/j.yebeh.2020.107197

Cited by 9 publications

(13 citation statements)

References 25 publications

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“…Their mean age was 36 years. Consistent with previous studies, [33][34][35][36][37] PNES patients were more likely to be female (77%) and the majority were unemployed (61%) and single…”

Section: Patient Characteristicssupporting

confidence: 89%

“…The participants completed these questionnaires before their final diagnosis facilitating more unbiased answers. The study population and setting may have limited generalizability to other age groups or cultures35; yet our patient cohort characteristics have been validated from previous inpatient and outpatient studies. For practical reasons,38 we selected to dichotomize our patients to 2 major semiological groups and did not follow more complex semiological classifications that were previously shown to have modest inter-rater reliability 45…”

Section: Discussionmentioning

confidence: 99%

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Translating Phenomenology of Psychogenic Nonepileptic Seizures Into Nosology

et al. 2021

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Background: Patients with psychogenic nonepileptic seizures (PNES) can be semiologically dichotomized into those with hyperkinetic and those with paucikinetic events. The objective of this study was to compare characteristics of patients with diverse phenomenology and their caregivers to evaluate for differences that could inform about disease nosology. Methods: Patients and caregivers monitored at the Epilepsy Monitoring Unit completed surveys about sociodemographic and disease characteristics, treatment and health care utilization, physical and psychosocial impact, and epilepsy knowledge. Patients were classified into hyperkinetic versus paucikinetic based on their recorded events. Comparison of the 2 populations was performed using Student t test for continuous variables and Fischer exact test for categorical variables. Results: Forty-three patients with Epilepsy Monitoring Unit confirmed PNES and 28 caregivers were enrolled. Patients with hyperkinetic events were more commonly non-White patients and necessitated greater caregiving time. Otherwise, no statistically significant differences were seen between the 2 semiologically diverse groups of patients and caregivers in their sociodemographic (age, sex, employment, income, marital, and education) and disease (age of onset, duration, seizures frequency) characteristics, treatment (number of antiseizure medications before diagnosis, side effects) and health care utilization (emergency room visits, hospitalizations, clinic visits), physical (injuries) and psychosocial (depression, anxiety, quality of life, stigma, burden) characteristics, nor in their knowledge about seizures. Conclusions: Hyperkinetic events were more frequently encountered in non-White patients and required more caregiving time. Further research is required to elucidate if phenomenological dichotomy of PNES can inform about their nosological basis, and if it can guide treatment and define prognosis.

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“…Their mean age was 36 years. Consistent with previous studies, [33][34][35][36][37] PNES patients were more likely to be female (77%) and the majority were unemployed (61%) and single…”

Section: Patient Characteristicssupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Translating Phenomenology of Psychogenic Nonepileptic Seizures Into Nosology

et al. 2021

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“…It is also important to highlight that the parity between among the results obtained and the data present in the current literature reinforce a cross-cultural character of the FND, since the cited studies present data from countries from continents such as North America, Europe, Asia, Oceania and Africa, while our study was carried out in a South American country. 7 , 18 , 23 …”

Section: Discussionmentioning

confidence: 99%

“…Functional Seizures (FS) are described as paroxysmal events with behavior similar to epileptic seizures or syncope when considering the symptoms reported by the patient, however it has specific clinical characteristics, positive signs and are not caused by abnormal epileptiform neuronal activity. 7 , 8 Until these patients find care in specialized centers, it is common presumed to have epilepsy, taking an average 7.2 years to receive the correct diagnosis, which results in iatrogenic effects, such as the misuse of antiseizure medications. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Management of Functional Seizures and Functional Movement Disorder: A Cross-Sectional Comparative Study

Pasquale¹,

Teive²,

Heyde³

et al. 2022

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Introduction Functional neurological disorders (FND) are conditions that cause to alterations in nervous system functions. They are disabling and impair the quality of life of patients but that are potentially reversible provided they have specific management. Functional seizures (FS) and functional movement disorder (FMD) are among the most common subtypes. Studies suggest a strong overlap between FS and FMD; however, there are still no cross-sectional studies that compare the management between these two conditions. Thus, our focus was to carry out a research that compares how these two subtypes of FND are being managed, in addition to assessing rates of understanding and acceptance of a diagnosis of FND. Methods It is a cross-sectional study with data collected from medical records and interviews with two patients’ groups (FS and FMD) treated from a FND clinic of the public health system of Brazil. Results From 105 medical records of patients with FND analyzed, 60 participants were eligible and agreed to participate in this research, being FS (n = 31) and FMD (n = 29). Statistically significant differences (p < 0.05) were found in the use of antiseizure (FS > FMD), opioids (FMD > FS), multi-professional follow-up (FMD > FS) and rates of understanding and acceptance of an FND diagnosis (FMD > FS). Similarities were found in sociodemographic profiles, medical follow-up, psychiatric comorbidities and use of antidepressants, anxiolytics, antipsychotics and mood stabilizers between two conditions. Conclusion More similarities than differences in management were found between FS and FMD. Similarities may be related to overlaps in sociodemographic and clinical characteristics between the two groups. Differences may be related to specific issues of each patient and condition. Regardless of the group, patients who perform psychotherapeutic follow-up have higher rates of understanding and acceptance of an FND diagnosis.

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“…children, (Wyllie et al, 1999) veterans, (Salinsky et al, 2011) males (Oto et al, 2005), elderly patients (Behrouz et al, 2006)) and those with co-existent ES with FS (Baroni et al, 2016), in other socioeconomic settings (Teagarden et al, 2020) and countries. (Asadi-Pooya et al, 2020a)…”

Section: Future Directionsmentioning

confidence: 99%