Psychogenic nonepileptic seizures: clinical characteristics and outcome

Autor: Bastian Volbers, Katrin Walther, Katrin Kurzbuch, Laura Erdmann, Stephanie Gollwitzer, Johannes D. Lang, Müjgan Dogan Onugoren, Michael Schwarz, Stefan Schwab, Hajo M. Hamer
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Brain and Behavior, Vol 12, Iss 5, Pp n/a-n/a (2022)
Druh dokumentu: article
ISSN: 2162-3279
DOI: 10.1002/brb3.2567
Popis: Abstract Background Clinical characteristics, outpatient situation, and outcome in patients with psychogenic nonepileptic seizures (PNES) remain to be elucidated. Methods Patients diagnosed with PNES after video‐electroencephalography (EEG) monitoring (VEM) 03/2000–01/2016 at the Erlangen Epilepsy Center were surveyed between June 2016 and February 2017. Primary outcome was PNES cessation defined as no PNES episodes within > = 12 months prior to the interview. Secondary outcome variables included quality of life (QoL) and dependency. Sensitivity analysis included patients with proven PNES during VEM without comorbid epilepsy. Results Ninety‐nine patients were included (median age 38 (interquartile range (IQR 29–52)) years; 68 (69%) females, follow‐up 4 (IQR 2.1–7.7) years). Twenty‐eight (28%) patients suffered from comorbid epilepsy. Twenty‐five (25%) patients reported PNES cessation. Older age at symptom onset (odds ratio (OR) related to PNES cessation: 0.95 (95% CI 0.90–0.99)), comorbid epilepsy (OR 0.16 (95% CI 0.03–0.83)), anxiety disorder (OR 0.15 (95% CI 0.04–0.61)), and tongue biting (OR 0.22 (95% CI 0.03–0.91)) remained independently associated with ongoing PNES activity after adjustment. Sensitivity analysis (n = 63) revealed depressive disorder (OR 0.03 (95% CI 0.003–0.34)) instead of anxiety as independent predictor, while this seemed relevant only in patients older than 26 years at onset (OR 0.04 (95% CI 0.002–0.78) versus OR 0.21 (95% CI 0.02–1.84) in patients younger than 26 years). PNES cessation was associated with increased median QoL (8 (IQR 7–9) versus 5.5 (IQR 4–7); p
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