Diagnostic Yield of 8-Hour Video-EEG in Detecting Psychogenic Non-Epileptic Seizures (PNES)

Katyal, Roohi; Paul, Aruna; Xu, Chao; Nouh, Claire Delpirou; Clanton, Austin; David, Sarah Paige Whitson; Dayyoub, Tammam

doi:10.1080/21646821.2021.2001246

Cited by 1 publication

(1 citation statement)

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“…Cohort studies suggest that, among patients attending an epilepsy monitoring unit, chronic pain is more common in patients with functional seizures than epilepsy and can aid in the differential diagnosis. [7][8][9][10][11] One of these studies described chronic pain symptoms in 30/332 (9%) patients with functional seizures, compared with 24/747 (3%) patients with epilepsy. 7 Using this and other clinical data, the authors developed a prospectively validated diagnostic score to differentiate between functional seizures and epilepsy, which placed a high weight on a patient's history of chronic pain as a distinguishing feature (log odds ratio difference=5.1).…”

Section: Pain In Fnd Compared With Other Neurological Disordersmentioning

confidence: 99%

Pain and functional neurological disorder: a systematic review and meta-analysis

Steinruecke,

Mason,

Keen

et al. 2024

J Neurol Neurosurg Psychiatry

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BackgroundFunctional neurological disorder (FND) is characterised by neurological symptoms, such as seizures and abnormal movements. Despite its significance to patients, the clinical features of chronic pain in people with FND, and of FND in people with chronic pain, have not been comprehensively studied.MethodsWe systematically reviewed PubMed, Embase and PsycINFO for studies of chronic pain in adults with FND and FND in patients with chronic pain. We described the proportions of patients reporting pain, pain rating and timing, pain-related diagnoses and responsiveness to treatment. We performed random effects meta-analyses of the proportions of patients with FND who reported pain or were diagnosed with pain-related disorders.ResultsSeven hundred and fifteen articles were screened and 64 were included in the analysis. Eight case–control studies of 3476 patients described pain symptoms in a higher proportion of patients with FND than controls with other neurological disorders. A random effects model of 30 cohorts found that an estimated 55% (95% CI 46% to 64%) of 4272 patients with FND reported pain. Random effects models estimated diagnoses of complex regional pain syndrome in 22% (95% CI 6% to 39%) of patients, irritable bowel syndrome in 16% (95% CI 9% to 24%) and fibromyalgia in 10% (95% CI 8% to 13%). Five studies of FND diagnoses among 361 patients with chronic pain were identified. Most interventions for FND did not ameliorate pain, even when other symptoms improved.ConclusionsPain symptoms and pain-related diagnoses are common in FND. Classification systems and treatments should routinely consider pain as a comorbidity in patients with FND.

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