No abstract

Epilepsy is a chronic neurological disease characterized by spontaneous and repeative seizures resulting in abnormal and excessive electrical discharge in cortical neurons [1]. In adults, epilepsy is the most common neurological disease after cerebrovascular diseases. It is important to be careful about the distinctive diagnosis of cases that are similar to clinical similarity but not epileptic feature [2]. Generally nonepileptic seizures (pseudoseizure); collected under two headings, depending on psychogenic and physiological reasons . Psychogenic nonepileptic seizures (PNES) is more common and the distinctive diagnosis is more difficult. PNES cases constitute 15-30% of patients who are refractory to pharmacological treatment who apply to epilepsy centers [3]. In a study of Bora et al, there was a 67 PNES cases in the case of 440 resistant epilepsy (15.2%) and all of these patients have been started the antiseizure medications in earlier centers reported [4].

Background: It has been reported that 10 to 30% of patients sent to epilepsy centers with a diagnosis of refractory epilepsy are diagnosed with psychogenic non-epileptic seizure (PNES). A wide variety of provocative methods are used to assist PNES diagnosis. Objective: To investigate the effect of seizure induction on the diagnosis and prognosis of PNES. Methods: We retrospectively examined 91 patients with PNES complaints in our video-EEG laboratory. Intravenous saline was administered to all patients for induction of seizures. Results: Saline injection was performed in 91 patients referred to our EEG lab with PNES initial diagnosis, 57 of whom were female and 34 male. Saline injection triggered an attack in 82 patients (90%). Conclusions: In this study we have concluded that provocative methods are practical, cheap and, most of all, effective for patient diagnosis. In clinical practice, explaining the diagnosis is the first and most important step of the treatment, and careful patient-doctor communication has a positive impact on patient prognosis.