Structural brain abnormalities in patients with psychogenic nonepileptic seizures

Asadi‐Pooya, Ali A.; Homayoun, Maryam

doi:10.1007/s10072-019-04108-7

Cited by 11 publications

(15 citation statements)

References 17 publications

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“…Additionally, our rate of image availability was low and matched prior similar studies [7,121,122]. While we did not observe associations between confounding factors and imaging availability, there likely was a bias to obtain neuroimaging in patients with a higher pretest probability of epilepsy or who had demonstrated abnormalities on outside imaging.…”

Section: Discussionsupporting

confidence: 74%

“…Consequently, clinicians may presume that neuroimaging of patients with FS would be normal, and abnormal neuroimaging should cast doubt on the diagnosis. However, multiple retrospective studies have demonstrated radiologically apparent abnormalities in 30% of magnetic resonance images (MRIs) from patients with FS without comorbid ES [7][8][9][10][11][12][13][14]. While the majority of these abnormalities were nonspecific, two previous studies found that 5-10% of them had definitive epilepsy-associated findings (EAF) including hippocampal sclerosis [7,10].…”

mentioning

confidence: 99%

“…However, multiple retrospective studies have demonstrated radiologically apparent abnormalities in 30% of magnetic resonance images (MRIs) from patients with FS without comorbid ES [7][8][9][10][11][12][13][14]. While the majority of these abnormalities were nonspecific, two previous studies found that 5-10% of them had definitive epilepsy-associated findings (EAF) including hippocampal sclerosis [7,10]. This rate of nonspecific abnormalities is markedly higher than healthy controls, who typically have nonspecific findings on 2-18% of MRIs, with the rate of EAF being too low to quantify reliably [15][16][17][18][19][20][21][22][23][24].…”

mentioning

confidence: 99%

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A minority of patients with functional seizures have abnormalities on neuroimaging

Kerr

Lee

Karimi

et al. 2021

Journal of the Neurological Sciences

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionsupporting

confidence: 74%

mentioning

confidence: 99%

mentioning

confidence: 99%

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A minority of patients with functional seizures have abnormalities on neuroimaging

Kerr

Lee

Karimi

et al. 2021

Journal of the Neurological Sciences

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“…Compared with the healthy population, no consistent structural brain imaging abnormalities have been identified in previous studies [9,12]. Consistent with many other studies, 36% of the whole cohort of patients with PNES in one study, and 27% of those with PNES-only had abnormal brain MRI findings [10][11][12][13][14]. This may suggest that structural brain abnormalities play a role in the development of PNES.…”

Section: Psychogenic Nonepileptic Seizures (Functional Seizures)supporting

confidence: 78%

“…However, prior to a definite diagnosis, patients with PNES are often investigated with neuroimaging. In one study, 40% of patients in a large cohort of PNES had a brain MRI, and this was associated with a higher seizure frequency and comorbid epilepsy [10]. In practice, it makes sense and is justifiable to perform a brain MRI in patients with suspected epilepsy, irrespective of whether they turn out to have PNES.…”

Section: Psychogenic Nonepileptic Seizures (Functional Seizures)mentioning

confidence: 99%

Unexpected brain imaging findings in patients with seizures

Mesraoua

Koepp

Schuknecht³

et al. 2020

Epilepsy & Behavior

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New imaging technologies have advanced our ability to localize the epileptogenic zone in patients with epilepsy. As a result of the constant improvement of the image quality, magnetic resonance imaging (MRI) has become the most important ancillary tool in the management of patients with epilepsy. Magnetic resonance imaging for the evaluation of patients with epilepsy should be done using a special temporal lobe protocol and read by physicians experienced with the findings in patients with epilepsy. On the other hand, in the healthy populations, incidental structural brain abnormalities have been reported in 18% of people. Incidental, subtle, or unexpected structural brain abnormalities have also been reported in many patients who were investigated because of having seizures. In the current narrative review, we will discuss some of these instances, where structural brain abnormalities are discovered unexpectedly, are subtle (but important) and/or may be considered as incidental.

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Are brain MRI abnormalities associated with the semiology of functional seizures?

et al. 2023

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Purpose To investigate whether radiologically apparent brain magnetic resonance imaging (MRI) abnormalities are associated with the functional seizure (FS) semiology. Methods All patients with a diagnosis of FS at the epilepsy centers at Shiraz University of Medical Sciences, Iran; Aichi Medical University Hospital, Japan; University of Michigan, USA; University of California, Los Angeles, USA; Emory University School of Medicine, USA; and Hospital el Cruce, Argentina, were studied. Results One hundred patients were included; 77 (77%) had motor functional seizures. Lobar location of brain abnormality did not have an association with the semiology (p = .83). There was no significant difference between ictal behaviors in patients with frontal or parietal lesions compared to those with temporal or occipital lesions. Conclusion There were no associations between functional seizure ictal behaviors and locations of the radiologically apparent brain MRI abnormalities. Further studies are needed to evaluate the underpinnings of varying behaviors in FS.

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Structural brain abnormalities in patients with psychogenic nonepileptic seizures

Cited by 11 publications

References 17 publications

A minority of patients with functional seizures have abnormalities on neuroimaging

A minority of patients with functional seizures have abnormalities on neuroimaging

Unexpected brain imaging findings in patients with seizures

Are brain MRI abnormalities associated with the semiology of functional seizures?

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