Frequency and economic burden of psychogenic non-epileptic seizures in patients applying for disability benefits due to epilepsy

Abstract

Background Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures and are often misdiagnosed as epilepsy. Objective To investigate the frequency of PNES and to calculate the economic burden of the patients who admitted to video-electroencephalographicmonitoring (VEM) to obtain a diagnosis of epilepsy in order to apply for disability retirement. Methods The present retrospective study included 134 patients who required disability reports between 2013 and 2019 and had their definite diagnoses after VEM. Following VEM, the patients were divided into three groups: epilepsy, PNES, and epilepsy + PNES. Results In total, 22.4% (n = 30) of the patients were diagnosed with PNES, 21.6% (n = 29) with PNES and epilepsy, and 56% (n = 75), with epilepsy. The frequency of PNES among all patients was of 44% (n = 59). In patients with PNES alone, the annual cost of using anti-seizure medication was of 160.67 ± 94.04 dollars; for psychostimulant drugs, it was of 148.3 ± 72.48 dollars a year; and the mean direct cost for diagnostic procedures was of 582.9 ± 330.0 (range: 103.52–1601.3) dollars. Conclusions Although it is challenging to determine the qualitative and quantitative total cost in these patient groups, early diagnosis and sociopsychological support will reduce the additional financial burden on the health system and increase the quality of life of the patients.

Psychogenic nonepileptic seizures: facts, emotions, and money

“…Pekos and coworkers concluded that early diagnosis and psychosocial support are key to reduce the financial burden on the health system, as well as, to increase the quality of life of PNES patients, after analyzing charts on 134 patients who applied to receive disability reports. 8 This is certainly a wishful goal and, at the same time, a rather challenging one. An editorial at Neurology discussed the delay between the onset of seizures and the correct diagnosis of PNES, estimating an average of 7 years, along with other shocking figures.…”