| Psychogenic non-epileptic seizures: our video-EEG experience. | |
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MedLine Citation:
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PMID: 21756548 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: The aim of our study was to assess the number of psychogenic non-epileptic seizures (PNES) in our patients with a refractory seizure disorder, to determine the 'typical' PNES semiology using video-EEG monitoring and describe other PNES parameters. METHODS: We evaluated prospectively 596 patients with pharmacoresistant seizures. All these patients underwent continuous video-EEG monitoring. In consenting patients, we used suggestive seizure provocation. We assessed seizure semiology, interictal EEG, brain MRI, psychiatric co-morbidities, personality profiles, and seizure outcome. RESULTS: In the sample of 596 monitored patients, we detected 111 (19·3%) patients with PNES. Of the 111 patients with PNES, 86·5% had spontaneous and 76·5% had provoked seizures. The five most typical symptoms were: initially closed eyelids (67·6%), rapid tremor (47·7%), asynchronous limb movement (37·8%), preictal pseudosleep (33·3%), and side-to-side head movement (32·4%). Interictal EEG was rated as abnormal in 46·2% and with epileptiform abnormality in 9%. Brain MRI was abnormal in 32 (28·8%) patients. Personality disorders (46·8%), anxiety (39·6%), and depression (12·6%) were the most frequent additional psychiatric co-morbidities. PNES outcome after at least 2 years is reported; 22·5% patients was seizure-free; one-third had markedly reduced seizure frequency. We have not seen any negative impact of the provocative testing on the seizure outcome. DISCUSSION: Video-EEG monitoring with suggestive seizure provocation supported by clinical psychiatric and psychological evaluation significantly contributes to the correct PNES diagnosis, while interictal EEG and brain MRI are frequently abnormal. Symptoms typical for PNES, as opposed to epileptic seizures, could be distinguished. |
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Authors:
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Tomáš Nežádal; Jiří Hovorka; Erik Herman; Iveta Němcová; Michal Bajaček; Eva Stichová |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurological research Volume: 33 ISSN: 1743-1328 ISO Abbreviation: Neurol. Res. Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-07-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7905298 Medline TA: Neurol Res Country: England |
Other Details:
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Languages: eng Pagination: 694-700 Citation Subset: IM |
Affiliation:
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Department of Neurology, Epileptology and Neuropsychiatry, Na Františku Hospital, Prague, Czech Republic. |
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