Document Detail


Psychogenic nonepileptic seizures in US veterans.
MedLine Citation:
PMID:  21893668     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Psychogenic nonepileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) and can result in significant long-term disability. We reviewed our experience with veterans undergoing seizure evaluation in the EMU to determine the time delay to diagnosis of PNES, the frequency of PNES, and cumulative antiepileptic drug (AED) treatment. We compared veterans with PNES to civilians with PNES studied in the same EMU.
METHODS: We reviewed records of all patients admitted to one Veterans Affairs Medical Center (VAMC) EMU over a 10-year interval. These patients included 203 veterans and 726 civilians from the university affiliate. The percentage of patients with PNES was calculated for the veteran and civilian groups. Fifty veterans with only PNES were identified. Each veteran with PNES was matched to the next civilian patient with PNES. The 2 groups were compared for interval from onset of the habitual spells to EMU diagnosis, cumulative AED treatment, and other measures.
RESULTS: PNES were identified in 25% of veterans and 26% of civilians admitted to the EMU. The delay from onset of spells to EMU diagnosis averaged 60.5 months for veterans and 12.5 months for civilians (p < 0.001). Cumulative AED treatment was 4 times greater for veterans with PNES as compared to civilians (p < 0.01). Fifty-eight percent of veterans with PNES were thought to have seizures related to traumatic brain injury.
CONCLUSIONS: The results indicate a substantial delay in the diagnosis of PNES in veterans as compared to civilians. The delay is associated with greater cumulative AED treatment.
Authors:
Martin Salinsky; David Spencer; Eilis Boudreau; Felicia Ferguson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurology     Volume:  77     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-06     Completed Date:  2011-10-31     Revised Date:  2012-02-22    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  945-50     Citation Subset:  AIM; IM    
Affiliation:
Portland Veterans Affairs Medical Center and Oregon Health & Sciences University, Portland, OR, USA. Salinsky@ohsu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain Injuries / diagnosis,  epidemiology,  psychology
Female
Hospitals, Veterans / trends
Humans
Male
Middle Aged
Retrospective Studies
Seizures / diagnosis,  epidemiology*,  psychology*
United States / epidemiology
Veterans*
Young Adult
Comments/Corrections
Comment In:
Neurology. 2012 Jan 17;78(3):225   [PMID:  22249500 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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