Health resource utilization among US veterans with psychogenic nonepileptic seizures: A comparison before and after video-EEG monitoring

Nunez-Wallace, Karen; Murphey, Dona K.; Proto, Daniel; Collins, Robert L.; Franks, Romay; Chachere, D. Michael; Chen, David K.

doi:10.1016/j.eplepsyres.2015.05.002

Cited by 18 publications

(14 citation statements)

References 31 publications

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“…Several studies have been conducted on health care resource utilization in PNES without estimating the costs involved . Our literature search yielded only four studies, three conducted in the United States and one from Ireland, describing health care utilization costs in PNES (Table ) .…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have been conducted on health care resource utilization in PNES without estimating the costs involved. [12][13][14][15] Our literature search yielded only four studies, three conducted in the United States and one from Ireland, describing health care utilization costs in PNES (Table 2). 6,9,16,17 Direct comparisons of those with our study are difficult due to variable methodologies used particularly in relation to the itemization and calculation of various costs, differences in health care delivery systems, and temporal variability of costs.…”

Section: Discussionmentioning

confidence: 99%

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Medical health care utilization cost of patients presenting with psychogenic nonepileptic seizures

Seneviratne

Low

et al. 2018

Epilepsia

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Summary Objective To investigate the health care utilization cost of patients presenting with psychogenic nonepileptic seizures (PNES) to a tertiary hospital in Australia. Methods This is a retrospective analysis of adult patients with PNES based on video‐electroencephalographic confirmation over a 5‐year period. We used an itemized list to collect detailed health care utilization data. The items included emergency room visits, hospital ward admissions, intensive care unit (ICU) admissions, outpatient neurology clinic visits, medical interventions, Code Blue and Medical Emergency Team calls for seizures, medications, and investigations. We calculated the cost of each individual item separately for each individual presentation. To investigate the proportional contribution of each covariate toward the total health care utilization cost, an analysis of the relative importance in the linear regression was performed. Results There were 39 patients, of whom seven (18%) were admitted to the ICU with suspected status epilepticus. The median total health care utilization cost per person until the diagnosis of PNES was established as 26 468 Australian dollars (AUD; 19 207 US dollars [USD]). In the item breakdown, the highest median cost was incurred by investigations (13 119 AUD = 9520 USD), followed by hospital ward management (8890 AUD = 6451 USD), ICU stay (3764 AUD = 2731 USD), outpatient neurology clinics (2200 AUD = 1596 USD), and emergency room visits (570 AUD = 413 USD). Nonepileptic psychogenic status (23%) and the duration of PNES disorder (10%) were the most significant variables contributing to the variance (R2) of the model. Significance A considerable burden of health care utilization cost is caused by PNES. The presence of nonepileptic psychogenic status and a longer duration of the condition predict a higher cost.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Medical health care utilization cost of patients presenting with psychogenic nonepileptic seizures

Seneviratne

Low

et al. 2018

Epilepsia

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“…The higher resource utilization is mainly related to a longer duration of FS due to misdiagnosis or delayed diagnosis. All studies in this field have consistently shown that ensuring confirmation of FS by video-EEG monitoring significantly reduces the costs associated with erroneous or delayed diagnosis of the condition [54] , [55] , [56] .…”

Section: Costsmentioning

confidence: 94%

Functional seizures are not less important than epilepsy

Asadi‐Pooya

Brigo

Tolchin³

et al. 2021

Epilepsy & Behavior Reports

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“…It has proved to be a safe and cost-effective investigation strategy (69,70). More specifically, a diagnosis of PNES based on results of prolonged inpatient video-EEG has been associated with substantial reductions in health care utilization (diagnostic and medication charges, outpatient and emergency visits) and costs (71)(72)(73).…”

Section: Indications For Prolonged Inpatient Video-eeg Recordingmentioning

confidence: 99%

Psychogenic non-epileptic seizures: an overview on terminology, epidemiology and diagnostic features

Brigo¹

2017

CCRE

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Psychogenic non-epileptic seizures (PNES) are paroxysmal events which may be misdiagnosed as epileptic seizures. However, unlike epileptic seizures, PNES are not caused by an excessive and hypersynchronous electrical activity in the brain and therefore are not accompanied by ictal electroencephalographic changes; they are common disorders, considered as an involuntary response to emotional, physical, psychological or social distress. This review focuses on terminology, epidemiology, and diagnostic difficulties encountered by physicians facing with this condition. It also provides a comprehensive overview of the diagnostic accuracy values (sensitivity and specificity) for clinical signs commonly used to support the diagnosis of PNES. The differential diagnosis between PNES and epileptic seizures may represent a diagnostic challenge, complicated by the coexistence of both conditions in some patients (up to 50%). The diagnostic delay for PNES is worrisome as a correct and prompt diagnosis is essential for an adequate therapy and to prevent unnecessary, costly and potentially harmful drug treatment. The diagnostic "gold standard" is a video-EEG recording of the paroxysmal event. Several physical signs have different sensitivity and specificity values in the differential diagnosis between PNES and epileptic seizures, but the diagnosis should never be driven by any single clinical sign alone. In doubtful cases, diagnosis should be carefully reconsidered checking event description and semiology at each visit, and not forgetting the possibility of a coexistence of both epilepsy and PNES.

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Health resource utilization among US veterans with psychogenic nonepileptic seizures: A comparison before and after video-EEG monitoring

Cited by 18 publications

References 31 publications

Medical health care utilization cost of patients presenting with psychogenic nonepileptic seizures

Medical health care utilization cost of patients presenting with psychogenic nonepileptic seizures

Functional seizures are not less important than epilepsy

Psychogenic non-epileptic seizures: an overview on terminology, epidemiology and diagnostic features

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