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Neurocase 2020 Jul 2:1-4. Epub 2020 Jul 2.

Department of Neurology, University of South Alabama Medical Center , Mobile, AL, USA.

The diagnosis of atypical paroxysmal events represents a significant challenge for clinicians when differentiating epileptic from nonepileptic events. The ictal manifestations of pharyngeal dysesthesias are often misdiagnosed and difficult to distinguish clinically, given their subtle features such as pharyngeal discomfort with and without autonomic symptomology. We report a rare case of isolated ictal pharyngeal dysesthesias localizing to the non-dominant frontal operculum lobe misdiagnosed as psychogenic and later confirmed by continuous video-EEG monitoring. Read More

Arch Acad Emerg Med 2020 20;8(1):e10. Epub 2020 Jan 20.

Department of laboratory science,chalous branch,islamic azad iniversity,chalous,iran.

Psychogenic non-epileptic seizures (PNES) are paroxysmal changes that mimic epileptic seizures, so often misdiagnosed and treated for epilepsy. PNES are considered a psychiatric illness, personality pathology, and experiential and behavioral manifestation of depression. Despite studies over the past two decades, the pathological mechanisms of this disorder are unclear. Read More

Epilepsy Behav 2020 Jun 27;111:107250. Epub 2020 Jun 27.

School of Medicine and Surgery, University of Milano Bicocca, Milano, Italy.

Epilepsy Behav 2020 Jun 26;111:107239. Epub 2020 Jun 26.

Department of Neurology, University Hospital of Tours, France.

Psychogenic nonepileptic seizures (PNES) resemble epileptic seizures (ES) but are not caused by the occurrence of excessive cortical neuronal discharge. Previous studies in German-, English-, and Italian-speaking patients showed that patients used a different communicative style to talk about their seizures. They demonstrated that the diagnosis between PNES and ES could be predicted using qualitative assessment and a diagnostic scoring aid (DSA). Read More

Clin Neurophysiol 2020 Jun 8;131(8):1902-1908. Epub 2020 Jun 8.

Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan, ROC; Departments of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan, ROC. Electronic address:

Objective: Numerous types of nonepileptic paroxysmal events, such as syncopes and psychogenic nonepileptic seizures, may imitate epileptic seizures and lead to diagnostic difficulty. Such misdiagnoses may lead to inappropriate treatment in patients that can considerably affect their lives. Electroencephalogram (EEG) is a commonly used tool in assisting diagnosis of epilepsy. Read More

Front Neurol 2020 2;11:461. Epub 2020 Jun 2.

Department of Neuroscience, Imaging and Clinical Science, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.

Psychogenic nonepileptic seizures (PNES) are neurobehavioral conditions positioned in a gray zone, not infrequently a no-man land, that lies in the intersection between Neurology and Psychiatry. According to the DSM 5, PNES are a subgroup of conversion disorders (CD), while the ICD 10 classifies PNES as dissociative disorders. The incidence of PNES is estimated to be in the range of 1. Read More

Epilepsy Behav 2020 Jun 17;111:107155. Epub 2020 Jun 17.

Division of Health Research, Lancaster University, Lancaster LA1 4YW, UK.

Background: There is no clear understanding of what causes and maintains nonepileptic attack (NEA) disorder (NEAD), or which psychological therapies may be helpful. The relationships between variables of psychological inflexibility: experiential avoidance (EA), cognitive fusion (CF), mindfulness, and key outcome variables in NEAD: somatization, impact upon life, and NEA frequency were investigated.

Method: Two hundred eighty-five individuals with NEAD completed validated measures online. Read More

Seizure 2020 May 18. Epub 2020 May 18.

Department of Developmental Neurology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland. Electronic address:

Purpose: The purpose of this study was to investigate the sensitivity and specificity of a standardized placebo protocol using a moist swab pad application in children and adolescents with psychogenic seizures vs epileptic seizures.

Methods: We retrospectively reviewed clinical data and video-EEG monitoring records with the standardized placebo protocol of 408 patients. Video -EEG diagnosis with PNES-consistent semiology was made in the context of clinical data by a two-certified epileptologist. Read More

Epilepsy Behav 2020 Jun 12;111:107197. Epub 2020 Jun 12.

Service de Neurologie, CHRU de NANCY et Pole Universitaire Adulte Du Grand Nancy, CPN, Laxou, France. Electronic address:

Purpose: We conducted a multicenter international cross-cultural comparative study to investigate clinical semiology and predisposing factors of functional seizures in a large cohort of patients living in different countries around the world. We hypothesized that semiology and predisposing factors of functional seizures differ between various world regions.

Methods: We conducted this retrospective observational study in adults with functional seizures admitted to epilepsy centers in Iran, Qatar, USA, France, Georgia, Egypt, and United Arab Emirates (UAE). Read More

Epilepsy Behav 2020 Jun 11;111:107183. Epub 2020 Jun 11.

Neuropsychiatry Service, St. George's Hospital, Blackshaw Road, London SW17 0QT, United Kingdom of Great Britain and Northern Ireland.

There is considerable debate in the literature regarding what to call functional seizures, with terms such as pseudoseizures, nonepileptic attack disorder (NEAD), and dissociative seizures being used. Provision of an accurate diagnosis and coherent explanation is a vital first step in the management of functional seizures and can result in cessation or reduced frequency for some individuals. This study investigated preferences for and offensiveness of terms used to describe functional seizures, and expectations for recovery with psychological treatment. Read More

Psychiatry Res 2020 May 31;290:113166. Epub 2020 May 31.

Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Purpose: If a positive family history of seizures plays a significant role that contributes to the risk for developing psychogenic nonepileptic seizures (PNES) by means of model learning, one would expect that patients with PNES with a family history of seizures show a different semiology than those without such a history. We investigated whether the above hypothesis is valid.

Methods: In this retrospective study, all patients with PNES, who were diagnosed at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, Iran, from 2008 until 2019, were investigated. Read More

Epilepsy Behav 2020 Jun 2:107150. Epub 2020 Jun 2.

Saskatchewan Epilepsy Program, Department of Medicine, Division of Neurology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address:

Objective: Psychogenic nonepileptic seizures (PNES) are one of the most common differential diagnoses of epilepsy. This study provides an overview of diagnostic and treatment services for patients with PNES across Latin America.

Methods: In 2017-2018, clinicians practicing in Latin America with responsibilities for patients with PNES were contacted to respond to a survey regarding the management of this disorder developed by the International League Against Epilepsy (ILAE) PNES Task Force. Read More

J Clin Neurophysiol 2020 May 26. Epub 2020 May 26.

Brain Sentinel, Inc., San Antonio, Texas, U.S.A.

Purpose: Epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) are difficult to differentiate when based on a patient's self-reported symptoms. This study proposes review of objective data captured by a surface electromyography (sEMG) wearable device for classification of events as ES or PNES. This may help clinicians accurately identify ES and PNES. Read More

Epilepsia 2020 Jun 5;61(6):1156-1165. Epub 2020 Jun 5.

Neurosciences Research Centre, St George's University of London, London, UK.

Objective: Dissociative traits represent a disturbance in selfhood that may predispose to, and trigger, functional seizures (FSs). The predictive representation and control of the internal physiological state of the body (interoception) are proposed to underpin the integrity of the sense of self ("minimal selfhood"). Therefore, discrepancies between objective and subjective aspects of interoception may relate to symptom expression in patients with FSs. Read More

Epilepsy Behav 2020 Jun 1:107160. Epub 2020 Jun 1.

Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA. Electronic address:

Objective: There is no information on disparities of patients with psychogenic nonepileptic seizures (PNES) and their caregivers. The objective of this exploratory study is to compare patients with PNES and caregivers with low socioeconomic status (SES) with those of high SES for disparities in healthcare use, seizures, medication adverse effects, psychosocial impact, and knowledge about epilepsy.

Methods: Patients with PNES and caregivers completed surveys about the aforementioned outcomes during their Epilepsy Monitoring Unit (EMU) admission. Read More

Neurosci Lett 2020 Aug 30;734:135097. Epub 2020 May 30.

Altinsehir Mahallesi 326. Sokak No:7 Daire:20, NILÜFER, Bursa, Turkey.

Background: The aim of this study is to determine the usefulness of Orexin-A levels in differentiating between epileptic seizures and psychogenic non-epileptic seizures in patients presenting to the emergency service with epileptic seizure-type symptoms.

Methods: A total of 80 individuals were included in this study, including 59 who presented to the emergency service within the first four hours of having been diagnosed with generalized tonic-clonic seizures (39 with epileptic seizures (ES) and 20 with pseudoseizures (PNES) and 21 controls. Orexin-A levels were measured in venous blood samples. Read More

Seizure 2020 May 14. Epub 2020 May 14.

Northeast Regional Epilepsy Group.

Purpose: To examine the effects of a three-session psychoeducational intervention on patients diagnosed with psychogenic non-epileptic seizures (PNES) in an Argentinian public hospital. It was hypothesized that patients would experience improvements in their understanding of PNES, illness perception and affective scores, but might not necessarily experience a significant change in post-traumatic and dissociative symptoms and in seizure frequency.

Methods: This study included 12 patients (10 women, 2 men) who were invited to participate in a psychoeducational group after receiving a V-EEG confirmed diagnosis of PNES. Read More

Brain Inform 2020 May 29;7(1). Epub 2020 May 29.

Department of Mathematics and Computer Science, Eindhoven University of Technology, TU/e, P.O.Box: 513, 5600MB, Eindhoven, NL, The Netherlands.

Epilepsy and psychogenic non-epileptic seizures (PNES) often show over-lap in symptoms, especially at an early disease stage. During a PNES, the electrical activity of the brain remains normal but in case of an epileptic seizure the brain will show epileptiform discharges on the electroencephalogram (EEG). In many cases an accurate diagnosis can only be achieved after a long-term video monitoring combined with EEG recording which is quite expensive and time-consuming. Read More

Epilepsy Behav 2020 Aug 22;109:107082. Epub 2020 May 22.

University of South Florida, 2 Tampa General Circle, Tampa, FL 33606, United States. Electronic address:

Psychiatr Clin North Am 2020 Jun 8;43(2):275-290. Epub 2020 Apr 8.

Brown University, Rhode Island Hospital, Potter 3, 593 Eddy Street, Providence, RI 02903, USA.

This article reviews common and clinically important neuropsychiatric aspects of epilepsy. Comorbidities are common, underdiagnosed, and powerfully impact clinical outcomes. Biological, psychological, and social factors contribute to the associations between epilepsy and neuropsychiatric disorders. Read More

Seizure 2020 Jul 26;79:30-43. Epub 2020 Apr 26.

Laboratory of Neurological Disorders, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy.

We searched Medline from 1946 to 2019 for reports exploring differences between PNES and other comparable paroxysmal events using clinical instruments, few of which focused on the differential diagnosis using broad-based questionnaires covering multiple aspects of this condition. The majority investigated single items to highlight specific differences, either qualitative or quantitative, between groups and to elucidate some of the pathogenetic mechanisms of PNES. We selected all variables that proved to be useful for differentiating PNES from other types of paroxysmal events and classified them by category, by instrument utilized and method of investigation. Read More

Seizure 2020 Jul 6;79:27-29. Epub 2020 May 6.

Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Purpose: We investigated the driving rate and the rate of road traffic accidents in patients with functional seizures. We hypothesized that road traffic accidents are common in these patients.

Methods: In this long-term study, all patients with functional seizures, who were diagnosed at Shiraz Comprehensive Epilepsy Center, Iran, from 2008 until 2018, were investigated. Read More

Br J Nurs 2020 May;29(9):506-511

Lecturer in Advanced Practice, Department of Health and Social Care, University of Derby.

Transient loss of consciousness (TLOC) accounts for 3% of all attendance in emergency departments within the UK. More than 90% of TLOC presentations are due to epileptic seizures, psychogenic seizures or syncope. However, in England and Wales in 2002, it was estimated that 92 000 patients were incorrectly diagnosed with epilepsy, at an additional annual cost to the NHS of up to £189 million. Read More

Pediatr Res 2020 May 11. Epub 2020 May 11.

Unit for Psychiatric Research, Psychiatry, Aalborg University Hospital, Aalborg, Denmark.

Background: Pediatric onset psychogenic nonepileptic seizures (PNES) is a highly disabling disorder and potentially misdiagnosed as epilepsy. Still, knowledge regarding PNES in children and adolescents is limited and data on both incidence and characteristics are scarce. This study investigated the incidence rate (IR) and clinical characteristics of pediatric onset PNES, including possible differences when having comorbid epilepsy. Read More

Epilepsy Behav 2020 Aug 7;109:107121. Epub 2020 May 7.

Private Practice, Cleveland, OH, United States of America.

Background: Identification of clinical features that might distinguish psychogenic nonepileptic seizures (PNES) from epileptic seizures (ES) is of value for diagnosis, management, and understanding of both conditions. Previous studies have shown that patients' descriptions of their seizures reflect differences in content and delivery. We aimed to compare verbal descriptions of PNES and ES using a mixed-methods approach. Read More

Clin EEG Neurosci 2020 May 4:1550059420918756. Epub 2020 May 4.

Department of Psychology, Uskudar University, Istanbul, Turkey.

. Psychogenic nonepileptic seizures (PNES), is one of the clinical manifestations of conversion disorder that epileptiform discharges do not accompany. Factors capable of increasing susceptibility to these seizures have not been adequately investigated yet. Read More

Psychother Psychosom Med Psychol 2020 Apr 30. Epub 2020 Apr 30.

Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité Universitätsmedizin Berlin.

Psychogenic non-epileptic seizures (PNES) occur in the context of various diseases. Therefore, PNES patients represent a heterogeneous group with different causative disorders. The etiology is still poorly understood. Read More

Epilepsy Res 2020 Jul 19;163:106342. Epub 2020 Apr 19.

Department of Neurology, The Royal Melbourne Hospital, Parkville, Australia; Department of Neurosciences, Alfred Health, Prahran, Australia; Central Clinical School, Monash University, Melbourne, Australia.

Objective: To identify factors associated with subjective cognitive complaints in people with presumed seizure disorders referred for video electroencephalogram monitoring (VEM).

Methods: Adult patients admitted for inpatient VEM were recruited. Objective cognitive function was measured with the Neuropsychiatry Unit Cognitive Screening Tool, subjective cognitive function with the Quality of Life in Epilepsy Inventory-89 subscales, and anxiety and depressive symptoms with the Hospital Anxiety and Depression Scale. Read More

Br J Psychiatry 2020 Mar;216(3):138-143

Researcher and Lecturer, Clinic for Psychiatry and Psychotherapy, Division of Psychosomatic Medicine and Psychotherapy, Universitaetskliniken des Saarlandes; and Head, Division of Psychosomatic Medicine and Psychotherapy, Universitaetskliniken des Saarlandes, Germany.

Background: Survivors of Islamic State of Iraq and Syria (ISIS) captivity are at high risk of developing mental disorders such as post-traumatic stress disorder (PTSD).

Aims: This study looks at the correlation between sexual abuse, shame, somatoform or bodily distress disorders, and dissociative seizures (psychogenic non-epileptic seizures).

Method: The psychological effects of traumatic events and dissociative seizure were assessed in Yazidi women who were held captive by ISIS in Northern Iraq between 2014 and 2018. Read More

Epilepsy Behav 2020 Jul 19;108:107090. Epub 2020 Apr 19.

Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, PA, USA. Electronic address:

Objectives: Opinions of healthcare professionals may shape their attitudes towards any given condition and patient population. The aim of the current study was to gather the views of healthcare providers on some of the issues on symptomatology and terminology of functional seizures (FS).

Methods: This was a questionnaire study that was sent to all neurologists and psychiatrists practicing in Fars province, Iran. Read More

Neurol Clin Pract 2020 Apr;10(2):96-105

Sheffield Teaching Hospitals NHS Foundation Trust (AW, RAG, SJH, MR), Royal Hallamshire Hospital; Division of Psychiatry and Applied Psychology (JJ-K), University of Nottingham, Institute of Mental Health, Innovation Park; Mental Health Liaison Team (MB), Derbyshire Healthcare NHS Foundation Trust Hartington Unit, Chesterfield; School of Mathematics and Statistics (TJH), University of Sheffield; Department of Clinical and Experimental Epilepsy (MK, SS, MCW), University College London Queen Square Institute of Neurology; NIHR Newcastle Biomedical Research Centre and Institute of Cellular Medicine (SWP), Newcastle University, Newcastle upon Tyne; and Academic Neurology Unit (MR), University of Sheffield, Royal Hallamshire Hospital, United Kingdom.

Background: Transient loss of consciousness (TLOC) is a common reason for presentation to primary/emergency care; over 90% are because of epilepsy, syncope, or psychogenic non-epileptic seizures (PNES). Misdiagnoses are common, and there are currently no validated decision rules to aid diagnosis and management. We seek to explore the utility of machine-learning techniques to develop a short diagnostic instrument by extracting features with optimal discriminatory values from responses to detailed questionnaires about TLOC manifestations and comorbidities (86 questions to patients, 31 to TLOC witnesses). Read More

Cureus 2020 Mar 15;12(3):e7278. Epub 2020 Mar 15.

Pulmonology and Critical Care, State University of New York (SUNY) Upstate Medical University Hospital, Syracuse, USA.

Hyperosmolar hyperglycemic state (HHS) is a disorder that occurs most frequently in type 2 diabetics and is associated with high mortality - up to 50%. Hypernatremia, when associated with HHS, worsens the prognosis. Encephalopathy is evident at a serum sodium level greater than 160 mOsm/kg. Read More

Psychosomatics 2020 Jul - Aug;61(4):343-352. Epub 2020 Feb 22.

Functional Neurology Research Group, Cognitive Behavioral Neurology Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Neuropsychiatry Unit, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address:

Background: Functional neurological disorder (FND) is a prevalent neuropsychiatric condition characterized by sensorimotor difficulties. Patients with FND at times report that sensory experiences trigger and/or exacerbate their symptoms. Sensory processing difficulties are also commonly reported in other psychiatric disorders frequently comorbid in FND, suggesting that contextualizing sensory profiles in FND within a biopsychosocial model may be clinically relevant. Read More

Psychosomatics 2020 Jul - Aug;61(4):353-362. Epub 2020 Feb 24.

Neuropsychiatry Clinic, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Department of Medical Neurobiology, Faculty of Medicine, Hebrew University of Jerusalem, Israel; Jerusalem Mental Health Center, Hebrew University Medical School, Jerusalem, Israel; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Background: Psychogenic nonepileptic seizures (PNES) represent one of the most sizable treatment challenges in neuropsychiatry. Although the underlying mechanism is far from being understood, several interventions have been suggested. However, patients with comorbid psychiatric diagnoses and epilepsy are excluded from most intervention studies. Read More

Arch Acad Emerg Med 2020 11;8(1):e18. Epub 2020 Mar 11.

Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: There is an increasing interest in the use of different biomarkers to help distinguish psychogenic non-epileptic seizure (PNES) from epileptic seizures (ES). This study aimed to evaluate the patterns of differentially expressed serum proteins in ES and PNES cases.

Methods: In this cross-sectional study, 4 patients with mesial temporal lobe epilepsy and 4 patients with PNES were selected from patients with history of recurrent seizures. Read More

Epilepsy Behav 2020 Aug 3;109:107063. Epub 2020 Apr 3.

Institute of Neurology, University "Magna Graecia", Germaneto, CZ, Italy; Neuroscience Research Center, University Magna Graecia, Catanzaro, Italy. Electronic address:

Epilepsy Behav 2020 May 23;106:107029. Epub 2020 Mar 23.

Epilepsy Center Bethel, Krankenhaus Mara, Bielefeld, Germany.

Purpose: Psychotherapy is recommended in patients with psychogenic nonepileptic seizures (PNES). To date, however, a limited number of studies have attempted to assess the long-term effectiveness of psychotherapy in patients with PNES. Here, we report the short and six-month follow-up seizure and psychopathological outcomes in patients with PNES who have undergone a combination of cognitive-behavioral individual and group therapy. Read More

J Neurol 2020 Jul 19;267(7):2164-2172. Epub 2020 Mar 19.

Neuroscience Research Centre, Institute of Molecular and Clinical Sciences, St. George's University of London, Cranmer Terrace, London, SW17 0RE, UK.

Functional neurological disorder (FND) is a common cause of persistent and disabling neurological symptoms. These symptoms are varied and include abnormal control of movement, episodes of altered awareness resembling epileptic seizures and abnormal sensation and are often comorbid with chronic pain, fatigue and cognitive symptoms. There is increasing evidence for the role of neurologists in both the assessment and management of FND. Read More

Epilepsy Res 2020 May 18;162:106298. Epub 2020 Feb 18.

Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Introduction: Video-EEG monitoring is one of the key investigations in epilepsy pre-surgical evaluation but limited by cost. This study aimed to determine the efficacy and safety of a 48-hour (3-day) video EEG monitoring, with rapid pre-monitoring antiepileptic drugs withdrawal.

Material And Methods: This is a retrospective study of epilepsy cases with VEM performed in University Malaya Medical Center (UMMC), Kuala Lumpur, from January 2012 till August 2016. Read More

Epilepsy Behav 2020 Apr 8;105:106991. Epub 2020 Mar 8.

Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: We investigated the rate of driving in patients with psychogenic nonepileptic seizures (PNES) from a large cohort in Iran. We hypothesized that these patients commonly do not drive. We also investigated the potential factors that may be associated with driving in these patients. Read More

Epilepsia 2020 Apr 10;61(4):758-765. Epub 2020 Mar 10.

Sheffield Teaching Hospitals National Health Service Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK.

Objective: To look for evidence of peri-ictal social interaction in psychogenic nonepileptic seizures (PNES) and epileptic seizures exploring the notion of PNES as a form of nonverbal communication.

Methods: Video recordings of typical seizures experienced by patients with epilepsy and PNES were obtained in a naturalistic social setting (residential epilepsy monitoring unit). Video analysis by three nonexpert clinicians identified 18 predefined semiological and interactional features indicative of apparent impairment of consciousness or of peri-ictal responsiveness to the social environment with assessment of interrater reliability using Fleiss κ. Read More

Cureus 2020 Jan 24;12(1):e6767. Epub 2020 Jan 24.

Neurology, Marshall University School of Medicine, Huntington, USA.

Background The main focus of this study is to aid early identification of psychogenic non-epileptic seizure (PNES) patients by identifying physical and psychosocial characteristics to reduce the health care burden, to reduce the unnecessary use of anti-epileptic medications and their side effects, and maximizing cost-effective use of video electroencephalography (VEEG). Methods We analyzed PNES subject data from VEEG monitoring performed at the Epilepsy Center at the Marshall University School of Medicine. We reviewed more than 360 episodes in 54 subjects older than 18 years (mean age ± standard deviation (SD): 48 ± 12. Read More

Seizure 2020 May 13;78:7-11. Epub 2020 Feb 13.

Northeast Regional Epilepsy Group, New York, United States.

Purpose: The term PNES refers to a conversion disorder that mimics epileptic seizures but has a psychological etiology. Recent studies report that in patients with PNES, there is reduced understanding of emotions, impulse control difficulties, and limited access to emotional regulation strategies. The aim of this study was to compare patients diagnosed with PNES with healthy volunteers on the presence of maladaptive emotional regulation. Read More

Neurol Sci 2020 Mar 4. Epub 2020 Mar 4.

Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: We investigated medical comorbidities in patients with psychogenic non-epileptic seizures (PNES). We hypothesized that these patients commonly have significant medical comorbidities.

Methods: In this retrospective study, all patients with PNES, who were diagnosed at Shiraz Comprehensive Epilepsy Center, Iran, from 2008 until 2019, were investigated. Read More

Epilepsy Behav 2020 Apr 29;105:106971. Epub 2020 Feb 29.

University of Nicosia, School of Social Sciences, Department of Psychology, Cyprus.

Purpose: The purpose of this study was to prospectively validate a care pathway for psychogenic nonepileptic seizures (PNES) in a pediatric setting. The pathway was developed based on a previous study of patients at our center, which demonstrated positive treatment outcomes of 80% full or partial remission. Sequentially referred patients with PNES in the validation cohort received care prospectively according to the pathway algorithm. Read More

Sensors (Basel) 2020 Feb 24;20(4). Epub 2020 Feb 24.

Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.

The diagnosis of psychogenic nonepileptic seizures (PNES) by means of electroencephalography (EEG) is not a trivial task during clinical practice for neurologists. No clear PNES electrophysiological biomarker has yet been found, and the only tool available for diagnosis is video EEG monitoring with recording of a typical episode and clinical history of the subject. In this paper, a data-driven machine learning (ML) pipeline for classifying EEG segments (i. Read More

Neurodiagn J 2020 Mar;60(1):36-40

Epilepsy Division, Mayo Clinic Florida, Jacksonville, Florida.

Tilt table testing is a common noninvasive diagnostic test performed to reproduce and evaluate syncope in a vulnerable patient and subsequently guide therapy. Electroencephalography (EEG) is typically useful for identifying interictal and ictal abnormalities within the context of epilepsy or suspected epilepsy. We report a series of patients who underwent simultaneous tilt table testing with EEG. Read More

Epilepsy Behav 2020 Apr 21;105:106940. Epub 2020 Feb 21.

Hacettepe University, School of Medicine, Department of Neurology, Ankara, Turkey.

Objectives: This study aimed to investigate the prevalence of psychogenic nonepileptic seizures (PNES) and PNES-epilepsy coexistence within all video-electroencephalography (EEG) monitoring unit (VEMU) referrals and to identify semiological and electrophysiological features to differentiate patients with PNES-epilepsy coexistence from PNES-only.

Methods: We retrospectively reviewed medical files, VEMU reports, and videos of 1983 adult patients. Demographical, historical, clinical, neuroimaging, and electrophysiological parameters of all patients were recorded. Read More

J Neuropsychiatry Clin Neurosci 2020 Feb 14:appineuropsych19080177. Epub 2020 Feb 14.

The Department of Psychiatry, Providence Veterans Affairs Medical Center (PVAMC), and Departments of Neurology and Psychiatry, Brown University, Providence, R.I. (LaFrance, Ho, Bhatla); the Division of Neuropsychiatry (LaFrance) and Division of Biostatistics (Baird), Rhode Island Hospital, Providence, R.I.; the Department of Neurology, Yale University, New Haven, Conn., and Department of Neurology, West Haven Veterans Affairs Medical Center, West Haven, Conn. (Altalib); and the Department of Psychiatry, Yale University, New Haven, Conn., and Department of Psychiatry, West Haven Veterans Affairs Medical Center, West Haven, Conn. (Godleski).

Objective: The authors compared baseline characteristics and reporting of psychosocial measures among veterans with seizures who were evaluated in-clinic or remotely via computer video telehealth (CVT). It was hypothesized that the CVT group would report less trauma history, drug use, and comorbid symptoms compared with veterans seen in-clinic.

Methods: A cross-sectional design was used to compare 72 veterans diagnosed with psychogenic nonepileptic seizures (PNES) or concurrent mixed epilepsy and PNES who were consecutively evaluated by a single clinician at the Providence Veterans Affairs Medical Center (PVAMC) Neuropsychiatric Clinic. Read More