Paroxysmal nonepileptic events in pediatric patients

Park, Eu Gene; Lee, Jiwon; Lee, Bo Lyun; Lee, Munhyang; Lee, Jeehun

doi:10.1016/j.yebeh.2015.05.029

Cited by 32 publications

(35 citation statements)

References 21 publications

(33 reference statements)

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“…This is in contrast with other authors who had previously described a decrease in the tendency of female predominance in younger groups of children when compared to adolescents (Patel et al, ; Kotagal, Costa, Wyllie, & Wolgamuth, ). Conversely, Park, Lee, Lee, Lee, and Lee () observed a high proportion of males with psychogenic nonepileptic seizures in younger patients and an equal distribution between both sexes in older patients. Rawat et al () found no gender differences, instead.…”

Section: Clinical Features Of Pediatric Pnesmentioning

confidence: 92%

Psychogenic nonepileptic seizures in pediatric population: A review

et al. 2019

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IntroductionPsychogenic nonepileptic seizures (PNES) are observable abrupt paroxysmal changes in behavior or consciousness that resemble epileptic seizures, but without concurrent electroencephalographic abnormalities.MethodsIn this manuscript, we reviewed literature concerning pediatric PNES and focused on those articles published in the last 10 years, in order to try to understand what the state of the art is at the moment, particularly as regards relationship and differential diagnosis with epilepsy.ResultsPsychogenic nonepileptic seizures have been extensively described in literature mainly in adults and less frequently in children. Despite the potential negative impact of a misdiagnosis (unnecessary investigations and antiepileptic drugs, structured pathological behavioral patterns), in literature there is little information regarding the real prevalence, clinical features, treatment, and outcome of PNES in children and adolescents.ConclusionPsychogenic nonepileptic seizures are common but frequently missed entity in pediatric population. Diagnosis could be difficult, especially in those children who have both epileptic and nonepileptic seizures; video EEG and home video can help clinicians in diagnosis. More studies are needed to better classify PNES in children and facilitate diagnosis and treatment.

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Section: Clinical Features Of Pediatric Pnesmentioning

confidence: 92%

Psychogenic nonepileptic seizures in pediatric population: A review

et al. 2019

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“…There are also no data on the number of pediatric patients with epilepsy; therefore, we first estimated the annual incidence and the total number of new epilepsy patients through related literature [12,26-32]. Then, we calculated the total number of new patients annually who presented with a paroxysmal event and were diagnosed as a nonepileptic event according to the ratio of the epileptic events to nonepileptic events in all paroxysmal events in children [33,34]. The proportion of infant patients was not available, so when calculating the total cost savings of bringing videos and choosing online consultation, we extended the age to 9 years and calculated the total cost savings for patients younger than 9 years nationwide.…”

Section: Methodsmentioning

confidence: 99%

Home Videos as a Cost-Effective Tool for the Diagnosis of Paroxysmal Events in Infants: Prospective Study

Huang

Wang

Liu

et al. 2019

JMIR Mhealth Uhealth

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Background The diagnosis of paroxysmal events in infants is often challenging. Reasons include the child’s inability to express discomfort and the inability to record video electroencephalography at home. The prevalence of mobile phones, which can record videos, may be beneficial to these patients. In China, this advantage may be even more significant given the vast population and the uneven distribution of medical resources. Objective The aim of this study is to investigate the value of mobile phone videos in increasing the diagnostic accuracy and cost savings of paroxysmal events in infants. Methods Clinical data, including descriptions and home videos of episodes, from 12 patients with paroxysmal events were collected. The investigation was conducted in six centers during pediatric academic conferences. All 452 practitioners present were asked to make their diagnoses by just the descriptions of the events, and then remake their diagnoses after watching the corresponding home videos of the episodes. The doctor’s information, including educational background, profession, working years, and working hospital level, was also recorded. The cost savings from accurate diagnoses were measured on the basis of using online consultation, which can also be done easily by mobile phone. All data were recorded in the form of questionnaires designed for this study. Results We collected 452 questionnaires, 301 of which met the criteria (66.6%) and were analyzed. The mean correct diagnoses with and without videos was 8.4 (SD 1.7) of 12 and 7.5 (SD 1.7) of 12, respectively. For epileptic seizures, mobile phone videos increased the mean accurate diagnoses by 3.9%; for nonepileptic events, it was 11.5% and both were statistically different (P=.006 for epileptic events; P<.001 for nonepileptic events). Pediatric neurologists with longer working years had higher diagnostic accuracy; whereas, their working hospital level and educational background made no difference. For patients with paroxysmal events, at least US $673.90 per capita and US $128 million nationwide could be saved annually, which is 12.02% of the total cost for correct diagnosis. Conclusions Home videos made on mobile phones are a cost-effective tool for the diagnosis of paroxysmal events in infants. They can facilitate the diagnosis of paroxysmal events in infants and thereby save costs. The best choice for infants with paroxysmal events on their initial visit is to record their events first and then show the video to a neurologist with longer working years through online consultation.

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“…Kim et al [11] reported that tonic posturing was the most common NPE in infancy, followed by staring. Park et al [8] also analyzed NPEs in children younger than 6 years of age and found that normal infant behavior (29.2%) was most commonly observed. Moreover, normal infant behaviors, such as repetitive grimacing, mouth twisting, crossing legs with cold sweats, and tonic-clonic arm movements, were prominent in this age group.…”

Section: Clinical Phenomena 1) Motor Symptomsmentioning

confidence: 99%

“…However, differentiation between true seizures and NPEs is difficult during infancy due to variations in semiology and incorrect history provided by parents or caregivers. Because of these difficulties, video electroencephalographic (VEEG) recording is required for a definitive diagnosis [6,8]. Although VEEG recording is the most accurate diagnostic method, it is difficult to perform in infants, and cannot easily be performed in all medical centers [5].…”

Section: Introductionmentioning

confidence: 99%

Semiological Features of Nonepileptic Paroxysmal Events in Infancy

2020

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Nonepileptic paroxysmal events (NPEs) are common in infancy and may be misinterpreted as epileptic seizures. With a knowledge of common NPEs, they can usually be diagnosed based on a detailed history and examination. So far, no studies have explored the semiological presentations of NPEs in infancy without video electroencephalographic (VEEG) recordings. We aimed to describe the phenomenology of NPEs in infancy to provide useful information to clinicians, enabling easier diagnoses without VEEG studies. Methods: We reviewed the medical records of 63 patients aged from 1 to 12 months diagnosed with NPEs at Daegu Catholic University Medical Center from September 2006 to June 2017. We classified the phenomenological features into five types: abnormal body movement, eye changes, breathing abnormalities, behavioral symptoms, and autonomic symptoms. Results: Of the 63 patients, 37 were male and 26 were female. The mean age at onset was 6 months, and the mean duration of symptoms was 22.5 days. Abnormal body movements were the most common feature (88.9%), followed by eye changes (31.7%), autonomic symptoms (11.1%), breathing abnormalities (6.3%), and behavioral abnormalities (3.2%). The most common type of abnormal body movements was shivering-like movement (32.1%). Initially, 30 patients (47.6%) were diagnosed with unclassified NPEs, nine (14.3%) with sleep myoclonus, six (9.5%) with benign paroxysmal tonic upward gaze, and five (7.9%) with benign myoclonus of infancy. During follow-up, two patients (3.2%) were diagnosed with epilepsy. Conclusion: Knowledge of the phenomenological characteristics of NPEs in infancy can be useful for making a correct diagnosis.

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Paroxysmal nonepileptic events in pediatric patients

Cited by 32 publications

References 21 publications

Psychogenic nonepileptic seizures in pediatric population: A review

Psychogenic nonepileptic seizures in pediatric population: A review

Home Videos as a Cost-Effective Tool for the Diagnosis of Paroxysmal Events in Infants: Prospective Study

Semiological Features of Nonepileptic Paroxysmal Events in Infancy

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