Evidence for epilepsy is rare in patients with psychogenic seizures

Lesser, Ronald P.; Lueders, Hans; Dinner, Dudley S.

doi:10.1212/wnl.33.4.502

Cited by 139 publications

(62 citation statements)

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“…Of 52 patients, 40% had no response, 23% had atypical events, and 37% had a typical event. Lesser et al (24) reported another patient in whom ES appeared with induction. Induction techniques have also been reported to trigger pseudo-status epilepticus, requiring aggressive therapy (10).…”

Section: Discussionmentioning

confidence: 99%

When Should Induction Protocols Be Used in the Diagnostic Evaluation of Patients with Paroxysmal Events?

et al. 1998

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Summary:Purpose: To determine the timing of spontaneous psychogenic nonepileptic events (PNEE) during video-EEG telemetry (VEEG), and the need to use induction protocols (IP).Methods: We studied 100 consecutive patients (75 females, 25 males) admitted to our inpatient VEEG unit from July 1994to June 1996 for differential diagnosis of paroxysmal events. We recorded the time to the first diagnostic spontaneous event, identified by the patient or a family member as typical. Episodes were classified as PNEE, physiologic nonepileptic events (PhysNEE), and epileptic seizures (ES). SD 54.1 h. In 82 patients, a diagnostic event occurred spontaneously. The first event was an ES in 22 patients, a PNEE in 53, and a Results:The mean duration of VEEG was 74 PhysNEE in 7. The time to first diagnostic event was significantly shorter for PNEE than for ES [15.0 ? SD 16.3 h (range 5 min to 58 h) vs. 28.6 ? SD 34.0 h (range 1-110 h) F = 15.621, p < 0.00011. In the first 24 h, 77.4% of the patients with PNEE had an event. By 48 h, all but 2 (96.2%) had had diagnostic events. After the first 58 h of monitoring, all patients with PNEE experienced a spontaneous diagnostic event.Conclusion: Spontaneous events can be expected to occur within 48 h in most patients with PNEE. Therefore, if IP are to be used as a diagnostic tool, we suggest that they be withheld during the initial 48 h of VEEG monitoring.

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Section: Discussionmentioning

confidence: 99%

When Should Induction Protocols Be Used in the Diagnostic Evaluation of Patients with Paroxysmal Events?

et al. 1998

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“…In several clinical series, the relative frequency of NES ranged from 5 to 20% in outpatient epilepsy populations (6,12,13) and from 10 to 40% in patients studied at epilepsy centers (13)(14)(15)(16)(17)(18)(19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

Incidence of Psychogenic Seizures in Adults: A Population‐Based Study in Iceland

1998

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Summary: Purpose: We wished to determine the incidence of psychogenic nonepileptic (NES) seizures in a population-based study.Methods: Cases were identified through review of the results of all long-term video-EEG studies made in Iceland during the study period.Results: The incidence of NES was 1.4 in 100,000 personyears of observation. Age-specific incidence was highest in the youngest age group (age 15-24 years) and decreased thereafter. A strong female preponderance was observed.Conclusions: The incidence of NES is equal to almost 4% of that reported for epilepsy from Iceland for persons aged 2 15 years. For people aged 15-24 years, the incidence of NES is equal to -5% of the incidence of epilepsy. Half the patients also had epilepsy. Key Words: Epidemiology-Epilepsy-Psychogenic nonepileptic seizures (NES) constitute a clinical phenomenon that resembles epileptic seizures. The diagnosis is based on recognition of typical clinical symptoms and recording of normal EEG during the episodes. The clinical diagnosis can be very difficult, and NES are frequently misdiagnosed as epileptic seizures. Long-term video-EEG monitoring (LVEM) has revolutionized the diagnosis of NES and several groups of researchers (1-6) have described the various clinical manifestations of NES. Correct diagnosis is important because inappropriate treatment for suspected epilepsy or suspected status epilepticus (SE) may be dangerous or life-threatening to the patient (7-10).The incidence of NES in a defined population is unknown, but investigators (9-1 3) have described the relative frequency of NES in selected patient groups. In Iceland, we conducted a study in which we identified all adult patients in the country first diagnosed with NES in a 5-year period.

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“…[19] Başka bir çalışmada psikojenik nöbetleri olan hastalarda %10 oranında epilepsi saptanmıştır. [20] Bizim olgularımızın da %12.5 (n=10) oranında non-epileptik psikojenik nöbet varlığı saptandı. Bu tablo kadın ve erkeklerde eşit oranlarda görülür.…”

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Demographic and clinical findings of patients with refractory epilepsy followed by the epilepsy department of the Ankara Education and Research Hospital

Genç¹,

Kutlu²,

Gömceli³

et al. 2013

Epilepsi

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SummaryObjectives: We aimed to examine the demographic and clinical characteristics of patients with refractory epilepsy and to question if further improvement can be achieved by re-evaluating the data. Methods: Eighty consecutive patients apparently resistent to medical anti-epileptic treatment and followed regularly throughout the last year were included in the study. Results: Mean age of the patients included in the study was 30.35±12.11 and the male to female number was 43 to 37. At the early phase of the study all patients were found to be taking more than one anti-epileptic drugs, 9 (11.3%) of whom received them in ineffective doses. Ten patients were decided to have non-epileptic psychogenic seizures as determined by clinical and EEG data. Re-handling the patients' management provided significant decrease in both complex partial and secondary generalized seizures (p<0.05). Conclusion: Even in patients with so-called refractory epilepsy, there may be a percentage responsive to treatment if evaluated and followed closely.

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Evidence for epilepsy is rare in patients with psychogenic seizures

Cited by 139 publications

References 0 publications

When Should Induction Protocols Be Used in the Diagnostic Evaluation of Patients with Paroxysmal Events?

When Should Induction Protocols Be Used in the Diagnostic Evaluation of Patients with Paroxysmal Events?

Incidence of Psychogenic Seizures in Adults: A Population‐Based Study in Iceland

Demographic and clinical findings of patients with refractory epilepsy followed by the epilepsy department of the Ankara Education and Research Hospital

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