Which patients with epilepsy are at risk for psychogenic nonepileptic seizures (PNES)? A multicenter case-control study.

Autor: Wissel BD; Department of Neurology and Rehabilitative Medicine, University of Cincinnati, Cincinnati, OH, USA., Dwivedi AK; Division of Biostatistics & Epidemiology, Department of Biomedical Sciences, Texas Tech University Health Sciences Center, El Paso, TX, USA., Gaston TE; Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA., Rodriguez-Porcel FJ; Department of Neurology and Rehabilitative Medicine, University of Cincinnati, Cincinnati, OH, USA., Aljaafari D; Division of Neurology, University of Toronto, Toronto, ON, Canada; Department of Neurology, King Fahad Hospital of the University, University of Dammam, Dammam, Saudi Arabia., Hopp JL; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA., Krumholz A; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA., van der Salm SMA; Department of Neurology, Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdam, Netherlands., Andrade DM; Division of Neurology, University of Toronto, Toronto, ON, Canada., Borlot F; Division of Neurology, University of Toronto, Toronto, ON, Canada., Moseley BD; Department of Neurology and Rehabilitative Medicine, University of Cincinnati, Cincinnati, OH, USA., Cavitt JL; Department of Neurology and Rehabilitative Medicine, University of Cincinnati, Cincinnati, OH, USA., Williams S; Department of Clinical Neurosciences, The University of Edinburgh, Edinburgh, Scotland, United Kingdom., Stone J; Department of Clinical Neurosciences, The University of Edinburgh, Edinburgh, Scotland, United Kingdom., LaFrance WC Jr; Department of Psychiatry and Neurology, Rhode Island Hospital, Brown University, Providence, RI, USA., Szaflarski JP; Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA., Espay AJ; Department of Neurology and Rehabilitative Medicine, University of Cincinnati, Cincinnati, OH, USA. Electronic address: alberto.espay@uc.edu.
Jazyk: angličtina
Zdroj: Epilepsy & behavior : E&B [Epilepsy Behav] 2016 Aug; Vol. 61, pp. 180-184. Date of Electronic Publication: 2016 Jun 27.
DOI: 10.1016/j.yebeh.2016.05.032
Abstrakt: Objective: We sought to examine the clinical and electrographic differences between patients with combined epileptic (ES) and psychogenic nonepileptic seizures (PNES) and age- and gender-matched patients with ES-only and PNES-only.
Methods: Data from 138 patients (105 women [77%]), including 46 with PNES/ES (39±12years), 46 with PNES-only (39±11years), and 46 with ES-only (39±11years), were compared using logistic regression analysis after adjusting for clustering effect.
Results: In the cohort with PNES/ES, ES antedated PNES in 28 patients (70%) and occurred simultaneously in 11 (27.5%), while PNES were the initial presentation in only 1 case (2.5%); disease duration was undetermined in 6. Compared with those with ES-only, patients with PNES/ES had higher depression and anxiety scores, shorter-duration electrographic seizures, less ES absence/staring semiology (all p≤0.01), and more ES arising in the right hemisphere, both in isolation and in combination with contralateral brain regions (61% vs. 41%; p=0.024, adjusted for anxiety and depression) and tended to have less ES arising in the left temporal lobe (13% vs. 28%; p=0.054). Compared with those with PNES-only, patients with PNES/ES tended to show fewer right-hemibody PNES events (7% vs. 23%; p=0.054) and more myoclonic semiology (10% vs. 2%; p=0.073).
Conclusions: Right-hemispheric electrographic seizures may be more common among patients with ES who develop comorbid PNES, in agreement with prior neurobiological studies on functional neurological disorders.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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