Differentiating psychogenic nonepileptic seizures from epileptic seizures: An observational study of patients undergoing video-electroencephalography (VEEG) in Australia

Jones, Maryon; Gaskell, J. F.; Lehn, Alexander

doi:10.1016/j.yebeh.2020.107542

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…In this study, we examined 25 patients identified in a previous study, 14 with an additional patient with FS captured on hospital-based EEGs with time-locked videorecording from July 2017 to July 2019. We categorized into the following classifications according to the reporting neurologist's assessment: (1) patients with pure FS (pFS) and (2) patients with mixed FS and coexisting epileptic seizures (FS + ES), including patients with both a clinical event without VEEG correlate and/or VEEG evidence of ES activity.…”

Section: Methodsmentioning

confidence: 99%

Health Care Utilization in Functional Neurologic Disorders

et al. 2023

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Background and ObjectiveThe objectives of this study were to investigate health care utilization costs of patients with video-electroencephalography (VEEG)–confirmed functional seizures (FS), determine whether patients who received a satisfactory functional neurologic disorder (FND) diagnosis explanation had reduced health care utilization compared with those with a poor explanation; and to quantify the overall health care costs 2 years prediagnosis and postdiagnosis for those receiving a different explanation.MethodsPatients with VEEG-confirmed pure FS (pFS) or mixed (functional seizure plus epileptic seizures) diagnosis between July 1, 2017, and July 1, 2019, were evaluated. Explanation of the diagnosis was determined “unsatisfactory” or “satisfactory” using self-developed criteria, and health care utilization data were collected using an itemized list. The subsequent costs 2 years post-FND diagnosis were compared with those 2 years before, and cost outcomes were compared between both groups.ResultsIn patients who received a satisfactory explanation (n = 18), total health care costs were reduced from $169,803 to $117,133 USD (−31%). An increase in costs was found ($73,430 to $186,553 USD = +154%) in patients with pPNES after an unsatisfactory explanation (n = 7). On an individual level, 78% with a satisfactory explanation saw a reduction in total health care costs per year (mean $5,111 USD to $1,728 USD), and in 57%, an unsatisfactory explanation led to an increase (mean $4,425 to $20,524 USD). A similar effect was seen from explanation on patients with a dual diagnosis.DiscussionThe method of communicating an FND diagnosis has a significant impact on subsequent health care utilization. Those receiving satisfactory explanations demonstrated reduced health care utilization, whereas an unsatisfactory explanation resulted in additional expenses.

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Section: Methodsmentioning

confidence: 99%

Health Care Utilization in Functional Neurologic Disorders

et al. 2023

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The neurobiology of functional neurological disorders characterised by impaired awareness

Milano

Moutoussis²,

Convertino³

2023

Front. Psychiatry

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We review the neurobiology of Functional Neurological Disorders (FND), i.e., neurological disorders not explained by currently identifiable histopathological processes, in order to focus on those characterised by impaired awareness (functionally impaired awareness disorders, FIAD), and especially, on the paradigmatic case of Resignation Syndrome (RS). We thus provide an improved more integrated theory of FIAD, able to guide both research priorities and the diagnostic formulation of FIAD. We systematically address the diverse spectrum of clinical presentations of FND with impaired awareness, and offer a new framework for understanding FIAD. We find that unraveling the historical development of neurobiological theory of FIAD is of paramount importance for its current understanding. Then, we integrate contemporary clinical material in order to contextualise the neurobiology of FIAD within social, cultural, and psychological perspectives. We thus review neuro-computational insights in FND in general, to arrive at a more coherent account of FIAD. FIAD may be based on maladaptive predictive coding, shaped by stress, attention, uncertainty, and, ultimately, neurally encoded beliefs and their updates. We also critically appraise arguments in support of and against such Bayesian models. Finally, we discuss implications of our theoretical account and provide pointers towards an improved clinical diagnostic formulation of FIAD. We suggest directions for future research towards a more unified theory on which future interventions and management strategies could be based, as effective treatments and clinical trial evidence remain limited.

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Differentiating psychogenic nonepileptic seizures from epileptic seizures: An observational study of patients undergoing video-electroencephalography (VEEG) in Australia

Cited by 2 publications

References 19 publications

Health Care Utilization in Functional Neurologic Disorders

Health Care Utilization in Functional Neurologic Disorders

The neurobiology of functional neurological disorders characterised by impaired awareness

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