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Epilepsy Curr 2019 Mar-Apr;19(2):1535759719841354

Adherence With Psychotherapy and Treatment Outcomes for Psychogenic Nonepileptic Seizures Tolchin B, Dworetzky BA, Martino S, et al. Neurology. 2019;92(7):e675-e679. Read More

Rev Prat 2019 Feb;69(2):214-218

Centre hospitalier universitaire de Nancy, unité d'épileptologie, Nancy, France.

Non-epileptic psychogenic seizures: a renewal approach of conversion disorders. Psychogenic non-epileptic seizures (PNES) are characterized by a paroxystic modification of behaviour or consciousness that resemble to an epileptic seizure. They are classified as dissociative or somatoform disorders. Read More

Neurol Sci 2019 Apr 14. Epub 2019 Apr 14.

Neuroscience Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.

Objective: We investigated the frequency of reported sexual abuse in patients with psychogenic nonepileptic seizures (PNES) in a Middle-Eastern culture (Iran) and tried to characterize the association between a history of sexual abuse and the clinical characteristics of PNES in these patients.

Methods: In this retrospective database study, patients with PNES, who were investigated at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 until 2018, were studied. Patients were categorized into two groups: (1) those with a history of sexual abuse and (2) those without such a history. Read More

Epilepsy Behav 2019 Apr 10;94:258-263. Epub 2019 Apr 10.

Department of Psychiatry, Government Medical College, Surat, India.

Background: Psychogenic nonepileptic seizures (PNES), the commonest nonepileptic event, represent 20-30% of drug-resistant epilepsy. Correct identification of PNES avoids unnecessary hospitalization and exposure of antiepileptic drugs (AEDs), and helps implement appropriate psychological treatment. Long-term video-electroencephalography (LTVEEG) is the gold standard test to diagnose PNES. Read More

Epilepsia 2019 Apr 13. Epub 2019 Apr 13.

Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Objective: We conducted a randomized controlled trial of motivational interviewing (MI) as an intervention to improve psychotherapy adherence and outcomes, including frequency of psychogenic nonepileptic seizures (PNES), quality of life, and emergency department utilization, among participants with PNES.

Methods: Sixty participants were randomized to receive either psychotherapy alone or MI plus psychotherapy. Participants and therapists were contacted at 16-week follow-up. Read More

Epileptic Disord 2019 Apr;21(2):192-196

Neuroscience Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.

The aim of this study was to investigate the frequency of loss of responsiveness (LOR) in patients with psychogenic non-epileptic seizures (PNES) and to characterize the patients' clinical variables that may be associated with such a manifestation. In this retrospective study, all patients with documented PNES, who were investigated at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 to 2018, were investigated. During the study period, data was available for 324/325 patients with PNES. Read More

Pol Arch Intern Med 2019 Apr 12. Epub 2019 Apr 12.

Epilepsy Behav 2019 Apr 5;94:183-188. Epub 2019 Apr 5.

Northeast Regional Epilepsy Group, United States of America.

Objective: The objective of the present study was to perform a long-term follow-up of economically disadvantaged Latin American patients diagnosed as having psychogenic nonepileptic seizures (PNES) and contribute to the field's understanding of outcome in this population.

Background: A handful of studies have examined outcome of patients once the diagnosis of PNES has been communicated. However, the vast majority of these have been conducted in the first world countries with samples that were predominantly Caucasian. Read More

Yonago Acta Med 2019 Mar 28;62(1):163-165. Epub 2019 Mar 28.

¶Division of Child Neurology, Department of Brain and Neurosciences, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.

We report an 8-year-old girl who experienced daily episodes of visual and somesthetic distortion and was diagnosed with Alice in wonderland syndrome (AIWS). Ophthalmologic assessment revealed best-corrected visual acuity of 0.2 in both eyes, and bilateral constricted tubular or spiral visual fields. Read More

Epilepsy Behav 2019 Apr 5;94:169-177. Epub 2019 Apr 5.

Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.

Purpose: Many patients with epilepsy or psychogenic nonepileptic seizures (PNES) experience high levels of stress. Although psychological interventions have been developed for seizure disorders, few patients can currently access them. We aimed to assess the acceptability and feasibility of a self-help intervention targeting stress in patients with seizures, and to provide preliminary evidence for its effectiveness. Read More

Epilepsy Behav 2019 Apr 5;94:167-168. Epub 2019 Apr 5.

Neuroscience Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: The aim of this study was to investigate the rate of consanguinity of parents of the patients with psychogenic nonepileptic seizures (PNES). This would provide important information for future studies on the potential genetic bases of PNES.

Methods: In this retrospective study, all patients with PNES, who were studied at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 to 2018, were recruited. Read More

Acta Neuropsychiatr 2019 Apr 1:1-5. Epub 2019 Apr 1.

1Department of Nuclear Medicine and PET Center,Aarhus University,Denmark.

Objective: Patients with psychogenic non-epileptic seizures (PNES) may present with convulsive events that are not accompanied by epileptiform brain activity. Video-electroencephalography (EEG) monitoring is the gold standard for diagnosis, yet not all patients experience convulsive episodes during video-EEG sessions. Hence, we aimed to construct a predictive model in order to detect PNES from serum hormone levels, detached from an evaluation of patients' convulsive episodes. Read More

Pediatr Neurol 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurology, Dell Medical School, Austin, Texas. Electronic address:

Background: Distinguishing patients with psychogenic nonsyncopal collapse (PNSC), a conversion disorder that resembles syncope, can pose a difficult clinical challenge. Using the open-ended question "what does it feel like to faint?," the present study aimed to characterize how patients with PNSC perceive and communicate the prodromal symptoms associated with their attacks by comparing narratives between patients with PNSC and those with syncope.

Methods: During a 42-month database-type study of tilt-table diagnoses, all patients with a history of fainting were asked the open-ended question. Read More

Continuum (Minneap Minn) 2019 04;25(2):492-507

Purpose Of Review: This review addresses the scope, evaluation, treatments, and outcomes of patients with nonepileptic episodic events with a focus on psychogenic nonepileptic seizures. Differentiation of the types of events, including a review of terminology, is included, as well as a brief review of special patient populations with these disorders.

Recent Findings: There are continued efforts to develop tools to improve the diagnosis of these disorders. Read More

Cureus 2019 Jan 16;11(1):e3902. Epub 2019 Jan 16.

Neurology, Marcus Neuroscience Institute at Boca Raton Regional Hospital, Boca Raton, USA.

Conversion disorder or a functional neurological symptom disorder is a psychiatric illness in which psychological conflicts are manifested as physical symptoms. Common examples of symptoms include blindness, paralysis, dystonia, anesthesia, inability to speak, difficulty swallowing, incontinence, balance problems, tremors, difficulty walking, hallucinations, and psychogenic non-epileptic seizures (PNES). Conversion disorder is often missed on initial medical and neurological evaluations due to the lack of a definitive organic diagnosis. Read More

Epilepsy Behav 2019 Mar 17;94:72-77. Epub 2019 Mar 17.

VA Portland Health Care System, Portland, OR, United States of America.

Rationale: Health-related quality of life (HRQoL) is compromised in civilians with epileptic seizures (ES) or psychogenic nonepileptic seizures (PNES). U.S. Read More

Seizure 2019 Mar 5;67:45-51. Epub 2019 Mar 5.

Department of Neurology, David Geffen School of Medicine at the University of California, Los Angeles (UCLA), Los Angeles, CA, USA.

Purpose: Differentiating psychogenic non-epileptic seizures (PNES) from epileptic seizures (ES) can be difficult, even when expert clinicians have video recordings of seizures. Moreover, witnesses who are not trained observers may provide descriptions that differ from the expert clinicians', which often raises concern about whether the patient has both ES and PNES. As such, quantitative, evidence-based tools to help differentiate ES from PNES based on patients' and witnesses' descriptions of seizures may assist in the early, accurate diagnosis of patients. Read More

Psychosomatics 2019 Feb 15. Epub 2019 Feb 15.

Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal; NOVA Medical School | Faculdade de Ciências Médicas - Universidade NOVA de Lisboa, Lisbon, Portugal.

Background: The construct of alexithymia includes a deficit in identifying and describing feelings. It has been proposed that alexithymia plays a role in the etiology of PNES but patients with epilepsy have also scored high on measures of alexithymia.

Objectives: To determine the prevalence of alexithymia in patients with psychogenic nonepileptic seizures (PNES) and to compare it with patients with epilepsy and healthy controls. Read More

Epilepsia Open 2019 Mar 30;4(1):210-215. Epub 2019 Jan 30.

Department of Neurology University of Massachusetts Medical School Worcester Massachusetts.

Epileptic seizures (ES) and psychogenic nonepileptic seizures (PNES) can be difficult to differentiate from each other in the emergency department (ED) setting. We have previously shown that the anion gap (AG) can help differentiate between ES and PNES in the ED. In this study, we explored whether additionally considering leukocytosis can help better differentiate between ES and PNES. Read More

Epilepsia Open 2019 Mar 19;4(1):54-62. Epub 2018 Dec 19.

Atkinson Morley Regional Neuroscience Centre St George's University Hospitals NHS Foundation Trust London UK.

Objective: Functional seizures are a common functional neurologic disorder. Given their chronic nature, and the biopsychosocial factors involved in their etiology, general practitioners (GPs) play a crucial role in the care of these patients. However, little is known about the attitudes of GPs toward, and knowledge of, functional seizures. Read More

J Neurol Neurosurg Psychiatry 2019 Mar 8. Epub 2019 Mar 8.

Radiology, Athinoula A Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, USA

Objective: Some individuals with functional neurological disorder (FND) exhibit motor and affective disturbances, along with limbic hyper-reactivity and enhanced motor-limbic connectivity. Given that the multimodal integration network (insula, dorsal cingulate, temporoparietal junction (TPJ)) is implicated in convergent sensorimotor, affective and interoceptive processing, we hypothesised that patients with FND would exhibit altered motor and amygdalar resting-state propagation to this network. Patient-reported symptom severity and clinical outcome were also hypothesised to map onto multimodal integration areas. Read More

Epilepsy Curr 2019 Jan 30;19(1):29-30. Epub 2019 Jan 30.

Psychiatric Comorbidity and Traumatic Brain Injury Attribution in Patients With Psychogenic Nonepileptic or Epileptic Seizures: A Multicenter Study of US Veterans Salinsky M, Rutecki P, Parko K, Goy E, Storzbach D, O'Neil M, Binder L, Joos S. Epilepsia. 2018. Read More

Epilepsy Curr 2019 Jan 30;19(1):31-32. Epub 2019 Jan 30.

Health Care Practitioners' Perceptions of Psychogenic Nonepileptic Seizures: A Systematic Review of Qualitative and Quantitative Studies Rawlings GH, Reuber M. Epilepsia. 2018;59(6):1109-1123. Read More

Epilepsia 2019 Apr 5;60(4):669-678. Epub 2019 Mar 5.

Department of Neurology, Epilepsy Center, University Hospital Erlangen, Erlangen, Germany.

Objective: To examine the long-term outcome of psychological status, personality, and health-related quality of life (HRQoL) in patients with psychogenic nonepileptic seizures (PNES) and to define predictors of favorable outcome of cessation of PNES.

Method: Patients diagnosed with PNES during video-electroencephalography (EEG) monitoring at the Erlangen Epilepsy Center were contacted 1-16 years after communicating the diagnosis. Follow-up information from each participant was obtained by interview (PNES outcome) and by self-reported questionnaires of psychological symptoms (Beck Depression Inventory-II, Symptom Checklist-90-Standard, Dissociative Symptoms questionnaire), personality traits (Freiburg Personality Inventory-Revised), and HRQoL (36-Item Short Form Health Survey). Read More

Clin Auton Res 2019 Apr 5;29(2):215-230. Epub 2019 Mar 5.

Clinical Neurocardiology Section, Clinical Neurosciences Program, Division of Intramural Research, National Institute of Neurological, Disorders and Stroke, National Institutes of Health, Bethesda, MD, 20892, USA.

This perspective piece on head-up tilt table testing is part of a series on autonomic function testing. The tilt table can be a useful diagnostic test, but methodologies vary, and the results are sometimes misinterpreted. The intent here is not to review comprehensively the utility of various tilt table testing protocols but to convey a number of general points that may give perspective and have practical clinical value, based on an understanding of autonomic physiology and our long clinical and research experience in the evaluation of autonomic disorders. Read More

Neurology 2019 Feb 25;92(9):e895-e904. Epub 2019 Jan 25.

From the Gertrude H. Sergievsky Center (M.C., M. Wall, D.H.), Columbia University, New York, NY; Academic Neurology Unit (J.J.-K., M.R.), Royal Hallamshire Hospital, University of Sheffield; Mental Health Liaison Team (M.B.), Derbyshire Healthcare NHS Foundation Trust Hartington Unit, Chesterfield; Department of Neurology (R.G., S.J.L.H.), Sheffield Teaching Hospitals NHS Foundation Trust; Department of Clinical and Experimental Epilepsy (M.K., S.M.S., M. Walker), Institute of Neurology, University College London; and Institute of Cellular Medicine (S.W.P.), Newcastle University, UK.

Objective: This retrospective study explores to what extent additional information from event witnesses provided using the novel 31-item Paroxysmal Event Observer (PEO) Questionnaire improves the differentiation among epilepsy, syncope, and psychogenic nonepileptic seizures (PNES) achievable with information provided by patients alone.

Methods: Patients with transient loss of consciousness caused by proven epilepsy (n = 86), syncope (n = 79), or PNES (n = 84) attending specialist neurology/syncope services in the United Kingdom and event observers provided Paroxysmal Event Profile (PEP), PEO, and personal information (PI) (e.g. Read More

Epilepsy Behav 2019 Feb 16;93:16-21. Epub 2019 Feb 16.

Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom; Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, United Kingdom.

Background: Seizure disorders affect not only the individual living with seizures, but also those caring for them. Carer-patient relationships may be influenced by, and have an influence on, some aspects of living with seizure disorders - with potentially different interactions seen in epilepsy and psychogenic nonepileptic seizures (PNES).

Objectives: We studied the influence of patient and carer attachment style and relationship quality on carer wellbeing and psychological distress, and explored whether these associations differ between carers for people with epilepsy and for those with PNES. Read More

Epilepsy Behav 2019 Feb 16;93:12-15. Epub 2019 Feb 16.

Department of Psychiatry and Medical Psychology, Faculdade de Medicina de São José do Rio Preto (FAMERP), Brazil. Electronic address:

Objective: The objective of this study was to verify if the presence of psychogenic nonepileptic seizures (PNES) could be a risk factor precluding corticoamygdalohippocampectomy (CAH) in patients with refractory temporal lobe epilepsy (TLE) and mesial temporal sclerosis (MTS) (TLE-MTS).

Methods: This retrospective cohort study analyzed medical data of patients with refractory TLE-MTS accompanied in a Brazilian epilepsy surgery center. Presurgical psychiatric evaluations were performed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Read More

Int J Neural Syst 2019 Jan 8:1850060. Epub 2019 Jan 8.

§ Department of Computer and Communication, National Pingtung University, 51 Min Sheng East Road, Pingtung, 90003, Taiwan.

Numerous nonepileptic paroxysmal events, such as syncope and psychogenic nonepileptic seizures, may imitate seizures and impede diagnosis. Misdiagnosis can lead to mistreatment, affecting patients' lives considerably. Electroencephalography is commonly used for diagnosing epilepsy. Read More

Seizure 2019 Mar 11;66:22-25. Epub 2019 Feb 11.

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

Purpose: The purpose of this study was to investigate the long-term outcome of patients with psychogenic nonepileptic seizures (PNES), who never visited a psychologist and never received a proper therapy for their condition (due to lack of resources). We also aimed to investigate factors potentially associated with the outcome in these patients.

Methods: We studied all patients with PNES, who were admitted to the epilepsy monitoring unit at the Shiraz Comprehensive Epilepsy Center, from 2008 until 2013. Read More

Brain Stimul 2019 Jan 31. Epub 2019 Jan 31.

CHU Lille, Hôpital Fontan, Department of Psychiatry, F-59000, Lille, France; Univ. Lille, CNRS UMR-9193, SCALab - Sciences Cognitives et Sciences Affectives, France; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Introduction: Psychogenic non-epileptic seizures (PNES) are paroxysms of either altered subjective or objective manifestations that may mimic epileptic seizures (ES), without abnormal neuronal epileptiform activity. In this report, we present the case of a 39-year-old woman with PNES and functional movement disorders, who was successfully treated with neuro-guided transcranial direct current stimulation (tDCS).

Methods: We used a PET-guided tDCS approach, as a hypometabolism of the frontal region was revealed by FDG TEP scan. Read More

Epilepsy Behav 2019 Mar 13;92:341-344. Epub 2019 Feb 13.

CAPHRI School for Public Health and Primary Care, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands; Centre for Economic Evaluation, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands.

Objectives: Psychogenic nonepileptic seizures (PNES) have the appearance of epileptic seizures, yet show no epileptiform discharges in the brain. The quality of life (QOL) in patients with PNES is reportedly low and trauma eems to be a relevant risk factor. The objective of this study was to examine the difference between measures of (epilepsy-specific) QOL (Quality of Life in Epilepsy Inventory; QOLIE-31p) and psychological dysfunction (trauma symptom inventory; TSI) between patients with diagnosed PNES with self-reported trauma and those without self-reported trauma. Read More

Epilepsy Behav 2019 Feb 11. Epub 2019 Feb 11.

Department of Psychiatry, Cleveland Clinic, United States of America.

Pinterest is a visual search based, the fourth largest social networking site in the U.S. with 81% of its users being women. Read More

FP Essent 2019 Feb;477:22-28

University of South Alabama College of Medicine Department of Family Medicine, 1601 Center Street, 2N Mobile, AL 36604.

Family physicians may be the first point of contact for adults with new-onset seizure. There are many etiologies of seizures in adults. Etiologies of provoked seizures include temporary metabolic disturbances, central nervous system infections, cerebrovascular disease, drug withdrawal, and traumatic brain injury. Read More

J Popul Ther Clin Pharmacol 2018 Jul 11;25(2):e1-e11. Epub 2018 Jul 11.

Dept of Neurology, Nizam's Institute of Medical Sciences, Hyderabad 500 082 India.

Objectives To study the clinical profile and outcome in patients with epilepsy who developed psychogenic non-epileptic seizures (PNES) associated with levetiracetam (LEV) use.   Methods In this prospective observational study, conducted over 1 year, 13 patients with epilepsy and PNES, documented by video electroencephalogram (VEEG) while on LEV, were included. Those with past history of psychiatric illnesses were excluded. Read More

Behav Sci (Basel) 2019 Jan 29;9(2). Epub 2019 Jan 29.

Department of Psychiatry, Griffin Memorial Hospital, Norman, OK 73071, USA.

Psychogenic non-epileptic seizures (PNES) are classified as a somatoform conversion disorder. We present a case of a 24-year-old male with a past psychiatric history of posttraumatic stress disorder (PTSD) and anxiety disorder, admitted to our inpatient psychiatric unit. The patient experienced multiple episodes of seizures during hospitalization. Read More

Seizure 2019 Feb 24;65:144-147. Epub 2019 Jan 24.

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

Purpose: The aim of this study was to investigate the frequency of dramatic presentations of psychogenic nonepileptic seizures (PNES) (i.e., urine incontinence and ictal injury) and to characterize the patients' historical risk factors that may be associated with such dramatic manifestations. Read More

Seizure 2019 Feb 17;65:124-128. Epub 2019 Jan 17.

Brigham and Women's Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA. Electronic address:

Purpose: Patients with psychogenic non-epileptic seizures (PNES) frequently complain of poor sleep, yet there are few and inconsistent data supporting objective sleep disturbances in this population. In this prospective observational study, we aimed to compare objective and subjective sleep-wake patterns in patients with PNES with those with epilepsy.

Methods: Subjects were recruited through the Brigham and Women's Epilepsy Monitoring Unit (EMU) over a 6-month period, and were diagnosed as having PNES or epilepsy by experts using video-electroencephalography (v-EEG). Read More

Epilepsy Behav 2019 Mar 23;92:206-212. Epub 2019 Jan 23.

The University of Melbourne, Department of Psychiatry, Austin Health, Heidelberg, VIC 3084, Australia; The Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC 3084, Australia; King's College London, Department of Psychological Medicine, Institute of Psychiatry, Weston Education Centre, Denmark Hill, London SE5 9RJ, UK. Electronic address:

Objectives: Psychogenic nonepileptic seizures (PNES) resemble seizures but are psychological in origin. The etiology of PNES remains poorly understood, yet several theories argue for the importance of autonomic dysregulation in its pathophysiology. We therefore conducted a retrospective study to investigate autonomic dynamics leading up to a seizure to inform their mechanistic relevance. Read More

Epilepsy Behav 2019 Mar 15;92:108-113. Epub 2019 Jan 15.

Northeast Regional Epilepsy Group, United States of America.

Objective: The objective of this study was to compare patients with intractable epilepsy with patients with psychogenic nonepileptic seizures (PNES) on the presence of psychological traumas, clinical factors, and psychological measures of somatization and dissociation.

Background: Several studies have reported a high prevalence of psychological trauma in patients with PNES, while less have examined the prevalence of psychological trauma in patients with epilepsy and compared both groups. Reports have been somewhat divergent with some describing significantly higher prevalence in physical abuse, others, in emotional abuse/neglect, and others, in sexual abuse in patients with PNES compared with those in patients with epilepsy. Read More

Neurology 2019 Feb 4;92(7):e675-e679. Epub 2019 Jan 4.

From the Comprehensive Epilepsy Center, Department of Neurology (B.T., H.B., L.J.H.), and Department of Psychiatry (S.M.), Yale University School of Medicine, New Haven, CT; Epilepsy Center of Excellence, Neurology Service (B.T.), and Psychology Service (S.M.), VA Connecticut Healthcare System, Newington; and Departments of Neurology (B.T., B.A.D.) and Psychiatry (G.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Objective: We conducted a prospective cohort study of patients with psychogenic nonepileptic seizures (PNES) to examine the association between adherence with psychotherapy and outcomes, including significant (≥50%) reduction in PNES frequency, PNES freedom, improvement in quality of life, and reduction in emergency department (ED) utilization.

Methods: A total of 105 participants were referred to receive psychotherapy either at Brigham and Women's Hospital or with a local therapist. We called participants at 12-24 months follow-up and obtained detailed follow-up data from 93 participants (89%). Read More

Neurology 2019 Feb 4;92(7):311-312. Epub 2019 Jan 4.

From the University of South Florida, Tampa.

Arch Cardiovasc Dis 2019 Feb 29;112(2):82-94. Epub 2018 Dec 29.

Service de neurophysiologie clinique, hôpital Roger-Salengro, CHRU de Lille, avenue du Professeur-Emile-Laine, 59037 Lille, France.

Background: Convulsive syncope and epileptic seizure share many similar clinical features. Early diagnosis is critical for choosing the appropriate management strategy.

Aim: Our aim was to evaluate the diagnostic yield of an innovative diagnostic strategy - combined head-up tilt test (HUT)/video electroencephalogram (EEG) monitoring - in patients with unexplained seizure-like transient loss of consciousness (T-LOC). Read More

Epilepsy Behav 2019 Mar 31;92:18-25. Epub 2018 Dec 31.

Vancouver General Hospital Epilepsy Program, Gordon and Leslie Diamond Health Care Centre, 8257 - 2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada; University of British Columbia Neuropsychiatry Program, Detwiller Pavilion, UBC Hospital, 2255 Wesbrook Mall, Vancouver, British Columbia, V6T 2A1, Canada. Electronic address:

Seizures are commonly thought to occur in a spontaneous, unpredictable manner. However, it is well-established that a subset of patients with epilepsy can experience reflex seizures that are consistently elicited by a specific stimulus. While various forms of reflex epilepsy have been documented in the literature, acute affective states have not been commonly described as a potential reflex seizure trigger. Read More

Epilepsy Behav 2019 Jan 20;90:172-177. Epub 2018 Dec 20.

Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA. Electronic address:

Objective: The objective of this study was to quantify the features of stereotypy in epileptic seizures and compare it with that of stereotypy in psychogenic nonepileptic seizure-like events (PNES) confirmed by video-electroencephalography (VEEG) monitoring.

Methods: Video-electroencephalography monitoring records of 20 patients with temporal lobe seizures (TLS) and 20 with PNES were retrospectively reviewed (n = 138 seizures, 48 TLS and 90 PNES). We analyzed the semiology of 59 behaviors of interest for their presence, duration, sequence, and continuity using quantified measures that were entered into statistical analysis. Read More

Seizure 2019 Jan 14;64:74-76. Epub 2018 Dec 14.

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

Purpose: The aim of this study was to investigate any possible association between education and psychogenic nonepileptic seizures (PNES) and any potential effects education might have on clinical characteristics of patients with PNES.

Methods: In this retrospective study, all patients with PNES, who were studied at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 until 2018, were recruited. We categorized the patients as 1. Read More

Epilepsy Behav 2019 Jan 19;90:191-196. Epub 2018 Dec 19.

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

Questionnaires or symptom lists have proved effective for differentiating epileptic seizures (ES) from psychogenic nonepileptic seizures (PNES). However, monitoring the events, corroborated by medical history gathered by experts, remains the gold standard. We directly compared symptoms and characteristic of the events self-reported by patients/eyewitnesses (Questionnaire A/B) with the information contained in the clinical charts of 50 patients with undefined diagnosis undergoing long-term monitoring. Read More

Epilepsia 2019 Feb 21;60(2):349-357. Epub 2018 Dec 21.

Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia.

Objective: To investigate the health care utilization cost of patients presenting with psychogenic nonepileptic seizures (PNES) to a tertiary hospital in Australia.

Methods: This is a retrospective analysis of adult patients with PNES based on video-electroencephalographic confirmation over a 5-year period. We used an itemized list to collect detailed health care utilization data. Read More

Neurology 2019 Jan 14;92(3):e194-e204. Epub 2018 Dec 14.

From the Departments of Medicine (S.S., Z.C., A.P., C.J.R., N.C.J., C.F., P.P., P.K., T.J.O.), Neurology (S.S., E.J.W., A.P., C.H., J.C., C.J.R., R.Y., C.F., P.P., P.K., T.J.O.), and Respiratory and Sleep Disorders Medicine (T.M., J.G.), The Royal Melbourne Hospital, The University of Melbourne, Parkville; Department of Neuroscience (S.S., Z.C., A.P., N.C.J., C.F., P.P., P.K., T.J.O.), Central Clinical School, Monash University; Department of Neurology (S.S., A.P., P.P., P.K., T.J.O.), The Alfred Hospital; and Neuropsychiatry Unit (S.F., D.V.), The Royal Melbourne Hospital and Melbourne Neuropsychiatry Centre, Australia.

Objective: To examine the prevalence and risk factors of sleep-disordered breathing (SDB) in individuals with epilepsy and psychogenic nonepileptic seizures (PNES).

Methods: We conducted a cross-sectional study of consecutive patients admitted for inpatient video-EEG monitoring at The Royal Melbourne Hospital, Australia, between December 1, 2011, and July 31, 2017. Participants underwent routine clinical investigations during their monitoring period including polysomnography, neurocognitive testing, and screening instruments of daytime somnolence, sleep quality, and quality of life. Read More