The value of pelvic thrusting in the diagnosis of seizures and pseudoseizures

Geyer, James D.; Payne, Troy A.; Drury, Ivo

doi:10.1212/wnl.54.1.227

Cited by 74 publications

(43 citation statements)

References 8 publications

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“…The difference was not statistically significant 22. In two uncontrolled studies, flailing or thrashing movements were observed in 18% and 19% of the patients with PNES 28 29. We therefore did not find sufficient evidence to suggest that the presence of flailing or thrashing movements can distinguish PNES from ES.…”

Section: Resultsmentioning

confidence: 73%

Does the primary literature provide support for clinical signs used to distinguish psychogenic nonepileptic seizures from epileptic seizures?

Avberšek

Sisodiya

2010

Journal of Neurology, Neurosurgery & Psychiatry

202

116

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Psychogenic nonepileptic seizures (PNES) represent a diagnostic challenge. When trying to distinguish between PNES and epileptic seizures (ES), clinicians rely on the presence or absence of several clinical signs. Our purpose is to establish the extent to which these signs are supported by primary data from the literature. A Medline search was used to identify primary studies that used video-EEG to define the presence or absence of different clinical signs in PNES and ES. The methodological quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. 34 studies matched the inclusion criteria. A specific sign was considered well supported by the data from the primary literature if we were able to identify at least two controlled studies demonstrating its usefulness and if the data from other studies were supportive. There is good evidence from the literature that long duration, occurrence from apparent sleep with EEG-verified wakefulness, fluctuating course, asynchronous movements, pelvic thrusting, side-to-side head or body movement, closed eyes during the episode, ictal crying, memory recall and absence of postictal confusion are signs that distinguish PNES from ES. Post-ictal stertorous breathing proved to distinguish convulsive PNES from generalised tonic clonic seizures (GTCS) and should be added to the list of useful clinical signs. The final clinical diagnosis should encompass all available data, and should not rely on any single sign alone.

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Section: Resultsmentioning

confidence: 73%

Does the primary literature provide support for clinical signs used to distinguish psychogenic nonepileptic seizures from epileptic seizures?

Avberšek

Sisodiya

2010

Journal of Neurology, Neurosurgery & Psychiatry

202

116

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“…Pelvic thrusting is most often seen in psychogenic seizures, but it has also been reported in frontal lobe seizures, sometimes combined with limb thrashing as part of hypermotor seizures, and less frequently in TLE. 5 Not all complex movements in TLE were of high amplitude: other patients displayed less violent and disorganized movements, such as repetitive body rocking. However, they were clearly distinct from typical automatisms and seemed unusual in the context of TLE.…”

Section: Resultsmentioning

confidence: 99%

Complex motor behaviors in temporal lobe epilepsy

Carreño

Donaire²,

Jiménez³

et al. 2005

Neurology

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“…Os movimentos pélvi-cos, embora tenham ocorrido em apenas 9 pacientes (19,1%), predominaram no sexo feminino (77,8%) 6,15,19 . Esta predominância foi evidenciada nos estudos realizados em portadores de epilepsias de lobo frontal, seguido das CNE 28 .…”

Section: Discussionunclassified

Monitorização vídeo-EEG prolongada em crises não epilépticas: semiologia clínica

Marques

Almeida

Santos

2004

Arq. Neuro-Psiquiatr.

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O objetivo deste estudo foi mostrar a contribuição da monitorização vídeo-EEG prolongada (MVEP) no diagnóstico de crises não epilépticas (CNE) e estimar sua prevalência em um centro terciário de atendimento à Epilepsia (EP). Foram observados 47 pacientes com diagnóstico de CNE com crises espontâneas ou provocadas. Foram instituídos protocolos direcionados à história clínica e à semiologia das crises. A análise estatística baseou-se no teste de Fisher e na análise de cluster. Os resultados evidenciaram prevalência de 10% de CNE. Houve predominância do sexo feminino (63,8%); em 57% dos pacientes as crises foram espontâneas. A média de idade foi 32,5 ± 11anos. O sinal semiológico mais freqüente foi o sono aparente (87,2%). Em 9% dos pacientes observaram-se tanto EP como CNE. Três agrupamentos resultaram da análise de cluster: CNE hipermotora das extremidades com alteração de tônus; CNE com automatismos e CNE axial com movimentos oculares. Em conclusão, o estudo da semiologia clínica das CNE durante a MVEP contribui para o diagnóstico desta entidade nosológica e para o diagnóstico diferencial com EP; o teste provocativo auxilia na obtenção das crises.

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The value of pelvic thrusting in the diagnosis of seizures and pseudoseizures

Cited by 74 publications

References 8 publications

Does the primary literature provide support for clinical signs used to distinguish psychogenic nonepileptic seizures from epileptic seizures?

Does the primary literature provide support for clinical signs used to distinguish psychogenic nonepileptic seizures from epileptic seizures?

Complex motor behaviors in temporal lobe epilepsy

Monitorização vídeo-EEG prolongada em crises não epilépticas: semiologia clínica

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