Differential Semiology Based on Video Electroencephalography Monitoring Between Psychogenic Nonepileptic Seizures and Temporal Lobe Epileptic Seizures

Lombardi, Nicolás; Scévola, Laura; Sarudiansky, Mercedes; Giagante, Brenda; Gargiulo, A.; Alonso, N.; Stivala, Ernesto González; Oddo, Silvia; Fernandez-Lima, Mónica; Kochen, Silvia; Korman, Guido Pablo; D’Alessio, Luciana

doi:10.1016/j.psym.2020.07.003

Cited by 7 publications

(10 citation statements)

References 38 publications

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Section: Methodsmentioning

confidence: 99%

“…However, VEEG is also indicated to carry out the differential diagnosis between ES (epileptic seizures) and PNES when there are diagnostic doubts. 19,29,[42][43][44] The aim of VEEG is to corroborate the existence of an electro-clinical correlation during the paroxystic events. PNES is confirmed when the typical episodes described by the patients or relatives, are present during VEEG, without associating any ictal epileptiform activity, and psychological aspects are involved.…”

Section: Clinical Semiology Of the Pnes; Differential Diagnosis With Epileptic Seizures And The Role Of Veegmentioning

confidence: 99%

“…PNES is confirmed when the typical episodes described by the patients or relatives, are present during VEEG, without associating any ictal epileptiform activity, and psychological aspects are involved. 19,43,44 As well VEEG is the gold standard to define the differential diagnosis, some semiological differences are described between PNES and epileptic seizures. The longer time duration of episodes is a common finding among patients with PNES.…”

Section: Clinical Semiology Of the Pnes; Differential Diagnosis With Epileptic Seizures And The Role Of Veegmentioning

confidence: 99%

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Updated Review on the Diagnosis and Primary Management of Psychogenic Nonepileptic Seizure Disorders

Lanzillotti

Sarudiansky

Lombardi

et al. 2021

NDT

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Psychogenic nonepileptic seizures (PNES) are paroxystic and episodic events associated with motor, sensory, mental or autonomic manifestations, which resemble epileptic seizures (ES), but are not caused by epileptogenic activity. PNES affect between 20% and 30% of patients attending at epilepsy centers and constitute a serious mental health problem. PNES are often underdiagnosed, undertreated and mistaken with epilepsy. PNES are diagnosed after medical causes (epilepsy, syncope, stroke, etc.) have been ruled out, and psychological mechanisms are involved in their genesis and perpetuation. For psychiatry, there is not a single definition for PNES; the DSM-IV and ICD-10/11 describe the conversion and dissociative disorders, and the DSM-5 describes the functional neurological disorders. However, patients with PNES also have a high frequency of other comorbidities like depression, particularly trauma and post-traumatic stress disorder. It has been postulated that PNES are essentially dissociations that operate as a defensive psychological mechanism that use the mind as a defense to deal with traumas. With the advent of VEEG in the 90s, the recognition of PNES has significantly increased, and several psychological treatments have been developed. In this manuscript, we carried out a state-of-the-art review, with the aim to provide a critical approach to the extensive literature about PNES, focusing on diagnostic aspects, the primary management, and the available treatments that have been shown to be effective for the improvement of PNES.

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Section: Methodsmentioning

confidence: 99%

Section: Clinical Semiology Of the Pnes; Differential Diagnosis With Epileptic Seizures And The Role Of Veegmentioning

confidence: 99%

Section: Clinical Semiology Of the Pnes; Differential Diagnosis With Epileptic Seizures And The Role Of Veegmentioning

confidence: 99%

See 1 more Smart Citation

Updated Review on the Diagnosis and Primary Management of Psychogenic Nonepileptic Seizure Disorders

Lanzillotti

Sarudiansky

Lombardi

et al. 2021

NDT

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“…These findings support the potential role of SPECT in the differential diagnosis of paroxysmal events of a psychogenic and an epileptic nature. Patients with PNES were predominantly females, as reported in the literature [5,7,12]. In only one patient the epileptogenic lesion exceeded the temporal lobe, consisting of a unilateral polymicrogyria involving the superior temporal lobe.…”

Section: Discussionmentioning

confidence: 63%

“…For the purpose of this research, ictal semiology and EEG recordings were reviewed. The description and semiological categorization of psychogenic episodes were carried out using a checklist based on major and minor clinical signs recognized in the literature [5][6][7][8]. Clinical episodes were first analysed independently by at least three observers (DR., ML, PB, AS), and then a joint analysis was carried out to define whether the semiology was consistent with a psychogenic event and confirm the absence of an electrical correlate in the ictal EEG.…”

Section: Clinical Informationmentioning

confidence: 99%