Predictors of early seizure remission after diagnosis of psychogenic nonepileptic seizures

Arain, Amir; Hamadani, Aley Muhammad; Islam, Shahidul; Abou‐Khalil, Bassel

doi:10.1016/j.yebeh.2007.07.017

Cited by 53 publications

(49 citation statements)

References 19 publications

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“…The average diagnostic delay of 7 to 10 years [21,[36][37][38] was similar to that of 7.8 years documented in our series. Few studies [11,17,39] have shown a shorter time for diagnosis.…”

Section: Discussionsupporting

confidence: 88%

Psychogenic non-epileptic seizures at a tertiary care center in Brazil

Alessi

Valente

2013

Epilepsy & Behavior

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Although psychogenic non-epileptic seizures (PNES) are a worldwide phenomenon, most of our knowledge addressing clinical characteristics is based on studies conducted in the USA, Europe, and Australia. There are scarce data about PNES in South American countries. This study provided a detailed analysis of the demographic, clinical, and psychosocial characteristics of 102 Brazilian patients with PNES. Seventy-eight patients (76.4%) were female with mean age of 35.27 years. Mean age at onset was 27.85 years; mean time to diagnosis was 7.89 years; 87.25% lived with their families; 56.89% were single; and only 33 (39.75%) worked on a regular basis. Depression was diagnosed in 48.03%. Thirty-three patients misdiagnosed as having epilepsy were using antiepileptic drugs. Stress factors were identified in 57.84%. This is the first Brazilian study that involves a large sample of patients with video-EEG-documented PNES and corroborates the idea that PNES are a worldwide phenomenon sharing several similarities, despite cultural and socioeconomic differences.

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“…The average diagnostic delay of 7 to 10 years [21,[36][37][38] was similar to that of 7.8 years documented in our series. Few studies [11,17,39] have shown a shorter time for diagnosis.…”

Section: Discussionsupporting

confidence: 88%

Psychogenic non-epileptic seizures at a tertiary care center in Brazil

Alessi

Valente

2013

Epilepsy & Behavior

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“…Psychogenic nonepileptic events are commonly divided into motor and motionless events (Arain et al, 2007;Meierkord et al, 1991;Selwa et al, 2000). We found that motionless staring events were more likely to be provoked with HV than the events with prominent motor symptoms.…”

Section: Discussionmentioning

confidence: 70%

Utility of Daily Supervised Hyperventilation During Long-Term Video-EEG Monitoring

Arain

Arbogast²,

Abou‐Khalil³

2009

Journal of Clinical Neurophysiology

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Hyperventilation (HV) is most effective in activation of generalized absence seizures during routine EEG studies. It is also used as an activation technique in the epilepsy monitoring unit, with limited data on its utility. This prospective study was undertaken to determine the effectiveness of daily hyperventilation sessions in precipitating events in the epilepsy monitoring unit. The authors performed hyperventilation for 3 minutes on a daily basis on patients admitted to our epilepsy monitoring unit. They considered events to be activated by HV if they occurred during or within 3 minutes of the procedure. They asked the patient if the precipitated event was typical, and compared the precipitated events to those that occurred spontaneously during the monitoring period. They evaluated 79 consecutive patients; 54 had localization related epilepsy, 24 had psychogenic nonepileptic events only, and 1 patient had spells of unknown nature. Six patients with epilepsy had epileptic seizure activation (three auras, two complex partial seizures and one secondarily generalized tonic clonic seizures), and eight patients with nonepileptic spells had precipitation of nonepileptic events. Two patients with both epilepsy and psychogenic nonepileptic events had a nonepileptic event activated. Spontaneous and activated epileptic seizures did not differ in their clinical characteristics. Daily supervised HV is effective in inducing partial seizures as well as psychogenic nonepileptic events in the epilepsy monitoring unit. Daily HV may be effective in shortening the duration of video EEG monitoring, consequently reducing its cost.

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“…In the second study, automatic clustering analysis between semiological categories was conducted to reveal five different clinical subtypes of events associated with PNES -dystonic attacks, pauci-kinetic attacks, pseudosyncope, hyperkinetic attacks, and axial dystonic attacks [19] -with substantial overlap between their classifications and previous classifications as discussed by the authors of both of these papers. The ability to classify patients within the subtypes of PNES is important because there is evidence that subtypes may be clinically relevant in terms of predicting outcome [17,21], informing nosology [16,17], and, perhaps most importantly, potentially directing treatment [22,23].…”

Section: Introductionmentioning

confidence: 99%