953 results match your criteria Seizures Psychogenic Nonepileptic


Working toward the ideal situation: A pragmatic Epi-Psy approach for the diagnosis and treatment of psychogenic nonepileptic seizures.

Epilepsy Behav 2021 May 5;120:108000. Epub 2021 May 5.

Service de Neurologie, CHRU Central Nancy, 54000 Nancy, France; Université Paris Descartes, Faculté de Médecine, 75006 Paris, France. Electronic address:

Medical international guidelines recommend regular psychiatric consultations for patients with epilepsy, in order to detect comorbidities. However, there is a lack of guidance about PNES that constitute both a differential diagnosis and a comorbidity of epilepsy. While waiting for the ideal collaboration between neurologists and psychiatrists, we develop a pragmatic approach. Read More

View Article and Full-Text PDF

Psychiatric burden in psychogenic nonepileptic seizures: The tip of the iceberg?

Epilepsy Behav 2021 Apr 30:107977. Epub 2021 Apr 30.

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

View Article and Full-Text PDF

Interictal dysphoric disorder in people with and without epilepsy.

Epilepsia 2021 Apr 15. Epub 2021 Apr 15.

Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation.

Objective: Interictal dysphoric disorder (IDD) has been regarded as an affective disorder occurring only in people with epilepsy (PWE). Data showing similar characteristics and similar prevalence of IDD in patients with migraine and with psychogenic nonepileptic seizures question the epilepsy-specific nature of IDD. The aim of the study was to investigate the nature of IDD in people with prevalent epilepsy with mood disorders and people with mood disorders who are free of neurological disease. Read More

View Article and Full-Text PDF

Localizing a metabolic focus during a functional seizure with fluorodeoxyglucose positron emission tomography-computed tomography.

World J Nucl Med 2021 Jan-Mar;20(1):96-98. Epub 2020 Jun 27.

Department of Psychiatry, Medical University of Vienna, Vienna, Austria.

Traumatic brain injuries can lead to long-term mental seizures that are difficult to differentiate from dissociative psychogenic symptoms, respectively, psychogenic nonepileptic seizures. Recent articles have drawn attention to the need of differentiation of psychological and brain trauma-related symptoms in survivors of violence. This case study reflects a diagnostic step in a 20-year-male who reported to have been subjected to torture, including blunt force to the head 2 years before examination. Read More

View Article and Full-Text PDF

Are Functional (Psychogenic Nonepileptic) Seizures the Sole Expression of Psychological Processes?

Curr Top Behav Neurosci 2021 Mar 26. Epub 2021 Mar 26.

Functional Neurological Disorder Research Program, Cognitive Behavioral Neurology and Neuropsychiatry Divisions, Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Functional [psychogenic nonepileptic/dissociative] seizures (FND-seiz) and related functional neurological disorder subtypes were of immense interest to early founders of modern-day neurology and psychiatry. Unfortunately, the divide that occurred between the both specialties throughout the mid-twentieth century placed FND-seiz at the borderland between the two disciplines. In the process, a false Cartesian dualism emerged that labeled psychiatric conditions as impairments of the mind and neurological conditions as disturbances in structural neuroanatomy. Read More

View Article and Full-Text PDF

A descriptive study of patients diagnosed with psychogenic nonepileptic seizures at a tertiary epilepsy center in the Czech Republic: One-year follow-up.

Epilepsy Behav 2021 May 19;118:107922. Epub 2021 Mar 19.

Epilepsy Center, Na Homolce Hospital, Prague, Czech Republic.

Purpose: To delineate sociodemographic data of a large sample of Czech Republic patients diagnosed with psychogenic non-epileptic seizures (PNES) at the time of diagnosis and at a follow-up visit one year after discharge. This study collected reports of past stressors, quality of relationships in childhood, family background, traumatic events, and recent adversities in patients diagnosed with PNES.

Method: Patients (219w/79m, 37. Read More

View Article and Full-Text PDF

Psychiatric comorbidities in patients with psychogenic nonepileptic seizures.

Epilepsy Behav 2021 May 15;118:107918. Epub 2021 Mar 15.

Department of Psychiatry, Alexandria University School of Medicine, Egypt.

Background: Psychogenic nonepileptic seizures (PNES) are major challenges for diagnosis and management. The heterogeneity of psychogenic seizures is attributed to diverse psychopathological comorbidities, and the causal relationship between PNES and underlying psychopathologies is still enigmatic.

Objective: Our objective was to study psychiatric comorbidities and personality constructs in patients with PNES and compare them to a control group of patients with epilepsy. Read More

View Article and Full-Text PDF

Clinical predictors of discordance between screening tests and psychiatric assessment for depressive and anxiety disorders among patients being evaluated for seizure disorders.

Epilepsia 2021 May 18;62(5):1170-1183. Epub 2021 Mar 18.

Department of Neurology, Alfred Health, Prahran, Victoria, Australia.

Objective: This study was undertaken to identify factors that predict discordance between the screening instruments Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Generalized Anxiety Disorder scale (GAD-7), and diagnoses made by qualified psychiatrists among patients with seizure disorders. Importantly, this is not a validation study; rather, it investigates clinicodemographic predictors of discordance between screening tests and psychiatric assessment.

Methods: Adult patients admitted for inpatient video-electroencephalographic monitoring completed eight psychometric instruments, including the NDDI-E and GAD-7, and psychiatric assessment. Read More

View Article and Full-Text PDF

Psychogenic Nonepileptic Seizures in Children and Adolescents.

Indian Pediatr 2021 Mar;58(3):259-265

Department of Psychiatry and Neurology, Riley Hospital for Children, Indiana University Medical Center, USA.

Context: Though psychogenic non-epileptic seizures (PNES) are seen commonly during evaluation of children and adolescents with epilepsy, the literature regarding developmental changes in PNES is limited.

Evidence Acquisition: Literature search was conducted in PubMed. Key search terms included: Pseudoseizure* OR PNES OR [(non-epileptic or nonepileptic or psychogenic or non-epileptic attack disorder) AND (seizure*)], resulting in 3,236 articles. Read More

View Article and Full-Text PDF

Surgical outcome of a female patient with comorbid epilepsy and psychogenic non-epileptic seizures confirmed with video-EEG monitoring.

Ann Transl Med 2021 Feb;9(3):273

Beijing Institute of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, China.

Despite common comorbidities of epileptic seizure (ES) and psychogenic nonepileptic seizure (PNES), reports regarding the clinical management of the two coexisting disorders have traditionally only focused on non-surgical approaches such as medication and psychotherapy. Epileptogenic zonectomy following comprehensive presurgical evaluation could lead to seizure control and even seizure free in refractory epilepsy patients. However, its effect on PNES which is of clinical significance remains to be explored. Read More

View Article and Full-Text PDF
February 2021

Psychiatric symptoms are the strongest predictors of quality of life in patients with drug-resistant epilepsy or psychogenic nonepileptic seizures.

Epilepsy Behav 2021 04 6;117:107861. Epub 2021 Mar 6.

The Departments of Medicine and Neurology, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia; Department of Neuroscience, Central Clinical School, The Alfred Hospital, Monash University, Victoria, Australia. Electronic address:

Objective: This cross-sectional study aimed to determine the effect of psychiatric comorbidity and neurocognitive deficits on the quality of life in a cohort of patients admitted for Video-EEG Monitoring (VEM) for investigation into a presumed seizure disorder.

Methods: Patients were recruited from an inpatient VEM unit between January 2009 and December 2016. All patients had formal neuropsychiatric assessment. Read More

View Article and Full-Text PDF

Evidence of objective sleep impairment in nonepileptic attack disorder: A naturalistic prospective controlled study using actigraphy and daily sleep diaries over six nights.

Epilepsy Behav 2021 04 5;117:107867. Epub 2021 Mar 5.

Department of Psychology, Queen's University Belfast, David Keir Building, Belfast, Northern Ireland, UK. Electronic address:

Poor sleep is reported by many with nonepileptic attack disorder (NEAD) with correlations evident between self-reported sleep quality and mood and functional impairment. However, it is contended that self-reported sleep impairment in NEAD is a subjective phenomenon, which represents a general tendency to over-report symptoms or misinterpret bodily states in those with NEAD. The present study was therefore designed to investigate the extent of subjective and objective sleep impairments in those with NEAD. Read More

View Article and Full-Text PDF

The COVID-19 outbreak and PNES: The impact of a ubiquitously felt stressor.

Epilepsy Behav 2021 04 12;117:107852. Epub 2021 Feb 12.

Department of Clinical Neuroscience, School of Medicine, Pontificia University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil; Service of Neurology, Hospital São Lucas, Pontificia University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.

Objective: We aimed to assess frequency of functional seizures or psychogenic nonepileptic seizures (PNES) during the COVID-19 outbreak and to recognize possible factors associated with worsening in this population.

Methods: In this cross-sectional study conducted during the second phase of the pandemic, adult patients with PNES documented by video-EEG and followed up in two tertiary epilepsy centers responded to a structured telephone survey. Data were gathered on demographics, clinical features and frequency of PNES, history of psychiatric comorbidity, access to treatment, as well as on anxiety (GAD-7 items) and depressive symptoms (NDDI-E). Read More

View Article and Full-Text PDF

Sleep Disturbances in Patients with Nonepileptic Seizures.

Nat Sci Sleep 2021 16;13:209-218. Epub 2021 Feb 16.

Department of Psychiatry, Faculty of Medicine and Dentistry, University Hospital, University Palacky Olomouc, Olomouc, 77520, The Czech Republic.

Objective: Up to 20% of patients treated for epileptic seizures experience psychogenic nonepileptic paroxysms (PNES). These patients present a significant burden for the health care systems because of poor treatment outcomes. The presented review aims to summarize the current state of knowledge on sleep disturbances in patients with nonepileptic seizures. Read More

View Article and Full-Text PDF
February 2021

Factors associated with delay to video-EEG in dissociative seizures.

Seizure 2021 Mar 15;86:155-160. Epub 2021 Feb 15.

Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.

Purpose: While certain clinical factors suggest a diagnosis of dissociative seizures (DS), otherwise known as functional or psychogenic nonepileptic seizures (PNES), ictal video-electroencephalography monitoring (VEM) is the gold standard for diagnosis. Diagnostic delays were associated with worse quality of life and more seizures, even after treatment. To understand why diagnoses were delayed, we evaluated which factors were associated with delay to VEM. Read More

View Article and Full-Text PDF

What do patients prefer their functional seizures to be called, and what are their experiences of diagnosis? - A mixed methods investigation.

Epilepsy Behav 2021 04 20;117:107817. Epub 2021 Feb 20.

Neuropsychiatry Service, St. George's Hospital, Blackshaw Road, London SW17 0QT, United Kingdom.

This study explored the preferred terms for functional seizures, and the experience of being diagnosed, from the patient's perspective. 39 patients in a neuropsychiatry service diagnosed with functional seizures completed an online survey to investigate preferences for, and offensiveness of, 11 common diagnostic terms used to describe functional seizures. Of these 39 patients, 13 consented to take part in a semistructured interview exploring the experience of receiving a diagnosis. Read More

View Article and Full-Text PDF

Home video prediction of epileptic vs. nonepileptic seizures in US veterans.

Epilepsy Behav 2021 04 18;117:107811. Epub 2021 Feb 18.

Neurology Care Line, VA Medical Center, Houston, TX 77030, USA; Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA. Electronic address:

Objective: Using video-EEG (v-EEG) diagnosis as a gold standard, we assessed the predictive diagnostic value of home videos of spells with or without additional limited demographic data in US veterans referred for evaluation of epilepsy. Veterans, in particular, stand to benefit from improved diagnostic tools given higher rates of PNES and limited accessibility to care.

Methods: This was a prospective, blinded diagnostic accuracy study in adults conducted at the Houston VA Medical Center from 12/2015-06/2019. Read More

View Article and Full-Text PDF

Power and pragmatism in functional neurological disorder research.

Epilepsy Behav 2021 04 17;117:107810. Epub 2021 Feb 17.

Melbourne School of Psychological Sciences, University of Melbourne, VIC 3010, Australia.

View Article and Full-Text PDF

Non-epileptic paroxysmal events in paediatric patients: A single tertiary centre study in Egypt.

Seizure 2021 Mar 10;86:123-128. Epub 2021 Feb 10.

Department of Paediatrics, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt.

Purpose: The misdiagnosis of non-epileptic seizures (NES) as epilepsy is one of the most common pitfalls in neuropsychiatric practice. This study aimed to describe the percentage and types of NES among children who were referred for a diagnosis of epilepsy in Upper Egypt.

Methods: We recruited a total of 876 patients who were referred to Sohag University Hospital, a tertiary referral centre in Upper Egypt, for the evaluation of suspected epilepsy. Read More

View Article and Full-Text PDF

Epilepsy, dissociative seizures, and mixed: Associations with time to video-EEG.

Seizure 2021 Mar 9;86:116-122. Epub 2021 Feb 9.

Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.

Purpose: Video-electroencephalographic monitoring (VEM) is a core component to the diagnosis and evaluation of epilepsy and dissociative seizures (DS)-also known as functional or psychogenic seizures-but VEM evaluation often occurs later than recommended. To understand why delays occur, we compared how patient-reported clinical factors were associated with time from first seizure to VEM (TVEM) in patients with epilepsy, DS or mixed.

Methods: We acquired data from 1245 consecutive patients with epilepsy, VEM-documented DS or mixed epilepsy and DS. Read More

View Article and Full-Text PDF

Short-term outcomes in pediatric and adolescent patients with psychogenic nonepileptic events seen by telemedicine during the COVID-19 pandemic.

Epilepsy Behav 2021 04 15;117:107739. Epub 2021 Feb 15.

Nationwide Children's Hospital, Department of Pediatrics, Division of Neurology, Columbus, OH, USA.

Introduction: Psychogenic nonepileptic events (PNEE) are a type of Functional Neurological Symptom Disorder that present with events that appear epileptic but are not associated with abnormal electrical activity in the brain. In response to the global COVID-19 pandemic, our PNEE clinic switched to a telemedicine format, and we present here our experience with providing care to children and adolescents with PNEE in this format.

Methods: The multidisciplinary clinic shifted to a telemedicine platform in March 2020 with the same joint provider format. Read More

View Article and Full-Text PDF

Psychogenic nonepileptic seizures: The effect of accurate diagnosis on cognition.

Epilepsy Behav 2021 04 12;117:107766. Epub 2021 Feb 12.

Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 Badalona, Spain.

Objective: Much remains to be elucidated about the cognitive profile of patients with psychogenic nonepileptic seizures (PNES) and about how this changes over time and compares to that of patients with epilepsy. The aim of this study was to study the neuropsychological profile of patients with PNES and an age-matched group of patients with temporal lobe epilepsy (TLE) during admission to a video electroencephalography monitoring unit (VEMU) and 1 year after discharge.

Methods: Patients diagnosed with PNES or TLE at a VEMU were prospectively recruited. Read More

View Article and Full-Text PDF

Breaking the spell: Narrative Medicine applications for Psychogenic Nonepileptic Seizures (PNES).

Authors:
Robert B Slocum

Seizure 2021 Mar 5;86:96-101. Epub 2021 Feb 5.

Narrative Medicine Program Coordinator, University of Kentucky HealthCare, Lexington, Kentucky, USA. Electronic address:

Narrative Medicine (NM) sessions draw out the patient's narrative of illness or injury and treatment in the context of the patient's whole life story. The focus is to discover topics and areas in the patient's narrative that the patient needs to explore. PNES may be understood in many cases as a communication disorder in which distress is expressed somatically in a pathological way instead of an adaptive and verbal manner. Read More

View Article and Full-Text PDF

Neurology specialists' visual interpretation of psychogenic nonepileptic seizures: Contemplating their etiology and existing challenges.

Seizure 2021 Jan 23. Epub 2021 Jan 23.

Pediatric Neurology Service, Pediatric Department, University of Antioquia, Medellín, Colombia.

Purpose: The purpose of this study was to explore how neurology specialists with interest in epilepsy depict psychogenic nonepileptic seizures (PNES) and their experience of diagnosing and treating the disorder.

Methods: An art project was organized as part of the curriculum of the 14th Latin American Summer School on Epilepsy (LASSE) in São Paulo (Brazil) from February 27th to March 6th, 2020. Willing neurologists were invited to draw or paint PNES and present their professional perspective of this disorder. Read More

View Article and Full-Text PDF
January 2021

Validation of a predictive calculator to distinguish between patients presenting with dissociative versus epileptic seizures.

Epilepsy Behav 2021 03 2;116:107767. Epub 2021 Feb 2.

Department of Neurology, University of Colorado, Aurora, CO, USA.

Dissociative seizures (also known as psychogenic nonepileptic seizures) are a common functional neurological disorder that can be difficult to distinguish from epileptic seizures. Patients with dissociative seizures provide diagnostic challenges, leading to delays in care, inappropriate care, and significant healthcare utilization and associated costs. The dissociative seizure likelihood score (DSLS) was developed by Kerr and colleagues at UCLA to distinguish between patients with epileptic seizures and dissociative seizures based on clinical and medication history as well as features of seizure semiology. Read More

View Article and Full-Text PDF

Distinguishing psychogenic nonepileptic, mixed, and epileptic seizures using systemic measures and reported experiences.

Epilepsy Behav 2021 03 2;116:107684. Epub 2021 Feb 2.

Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK. Electronic address:

Objectives: Our primary objective was to better discern features that can differentiate people with 'mixed' symptomatology from those who experience epileptic seizures (ES) or functional/psychogenic nonepileptic seizures (PNES) alone, in a population of patients referred for video-telemetry. We wished to see if we could establish the prevalence of PNES in this population of interest as well as compare both objective (e.g. Read More

View Article and Full-Text PDF

The relation of fibromyalgia and fibromyalgia symptoms to self-reported seizures.

PLoS One 2021 4;16(2):e0246051. Epub 2021 Feb 4.

Faculty of Behavioral Management & Social sciences, Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands.

Objective: Several epidemiological and clinical reports associate fibromyalgia (FM) with seizure disorders, and clinical studies associate FM diagnosis with psychogenic non-epileptic seizures. However, these associations rely on self-reports of being diagnosed with FM or unstandardized clinical diagnosis in combination with small samples. We investigated the association of FM and self-reported seizures using a large rheumatic disease databank and the current established self-reported, symptom-based FM diagnostic criteria. Read More

View Article and Full-Text PDF
February 2021

Latency to First Event is Shorter in Psychogenic Non-epileptic Seizures than in Epileptic Seizures in an Epilepsy Monitoring Unit.

Innov Clin Neurosci 2020 Jul;17(7-9):26-29

Drs. Sagi and Evans are with the Department of Neurology at the University of Louisville in Louisville, Kentucky.

The objective was to study latency to first event among patients with psychogenic nonepileptic seizures compared (PNES) to epileptic seizures (ES) in an epilepsy monitoring unit (EMU). PNES are common imitators of ES. This study investigates latency to first event in patients with PNES compared to patients with ES. Read More

View Article and Full-Text PDF

Predictive utility of the Minnesota Multiphasic Personality Inventory-2-RF (MMPI-2-RF) in differentiating psychogenic nonepileptic seizures and epileptic seizures in male veterans.

Epilepsy Behav 2021 03 29;116:107731. Epub 2021 Jan 29.

Michael E. DeBakey VA Medical Center, Rehabilitation Care Line, 2002 Holcombe Blvd., Houston, TX 77030, USA. Electronic address:

Objective: While psychogenic nonepileptic seizures (PNES) and epileptic seizures (ES) often present similarly, they are etiologically distinct, and correct diagnosis is essential for ensuring appropriate treatment and improving outcomes. The Minnesota Multiphasic Personality Inventory-2-RF (MMPI-2-RF) may assist in differential diagnosis, but prior investigations have been limited by disproportionately female samples, inconsistent accounting for profile invalidity, and limited intra-scale variability from dichotomizing variables. The current investigation addressed these gaps by assessing diagnostic utility of the MMPI-2-RF in differentiating PNES and ES in a male sample of veterans while conservatively accounting for profile invalidity and using a statistical approach that allows for consideration of continuous independent variables to better appreciate intra-scale variance. Read More

View Article and Full-Text PDF

Association of Epileptic and Nonepileptic Seizures and Changes in Circulating Plasma Proteins Linked to Neuroinflammation.

Neurology 2021 03 25;96(10):e1443-e1452. Epub 2021 Jan 25.

From Cognizance Biomarkers (J.M.G., E.J.B., R.D.S., T.M.W.), Spring House, PA; Christiana Care (J.R.P.), Newark, DE; and Department of Neurology (P.B.C.), University of Maryland, Baltimore.

Objective: To develop a diagnostic test that stratifies epileptic seizures (ES) from psychogenic nonepileptic seizures (PNES) by developing a multimodal algorithm that integrates plasma concentrations of selected immune response-associated proteins and patient clinical risk factors for seizure.

Methods: Daily blood samples were collected from patients evaluated in the epilepsy monitoring unit within 24 hours after EEG confirmed ES or PNES and plasma was isolated. Levels of 51 candidate plasma proteins were quantified using an automated, multiplexed, sandwich ELISA and then integrated and analyzed using our diagnostic algorithm. Read More

View Article and Full-Text PDF