Psychogenic non-epileptic seizures at a tertiary care center in Brazil

Abstract

Although psychogenic non-epileptic seizures (PNES) are a worldwide phenomenon, most of our knowledge addressing clinical characteristics is based on studies conducted in the USA, Europe, and Australia. There are scarce data about PNES in South American countries. This study provided a detailed analysis of the demographic, clinical, and psychosocial characteristics of 102 Brazilian patients with PNES. Seventy-eight patients (76.4%) were female with mean age of 35.27 years. Mean age at onset was 27.85 years; mean time to diagnosis was 7.89 years; 87.25% lived with their families; 56.89% were single; and only 33 (39.75%) worked on a regular basis. Depression was diagnosed in 48.03%. Thirty-three patients misdiagnosed as having epilepsy were using antiepileptic drugs. Stress factors were identified in 57.84%. This is the first Brazilian study that involves a large sample of patients with video-EEG-documented PNES and corroborates the idea that PNES are a worldwide phenomenon sharing several similarities, despite cultural and socioeconomic differences.

Neurological disorder-associated genetic variants in individuals with psychogenic nonepileptic seizures

“…Nevertheless, the detection of pathogenic variants that are likely to cause Mendelian forms of neurological or psychiatric disorders in individuals with PNES is in line with emerging evidence that neurological or psychiatric disorders share a broad range of pleiotropic acting genetic variation 8 , 11 , 31 . Our results are also in line with the observation that up to 48% of all individuals with PNES report a family history of epilepsy and 22% a family history of psychiatric disorders 6 . PNES could represent one of several clinically defined phenotypes associated with pleiotropic acting genetic variants, affecting genes essential for brain development and function.…”

“…Major depression and anxiety disorders are the most common psychiatric comorbidities, both reported in ~ 50% of all individuals with PNES 3 , 4 . PNES, epilepsy, and psychiatric disorders cluster in families with a positive family history of psychiatric disorders in 7–22% of all individuals with PNES 5 , 6 and a positive family history of epilepsy in 7–48% of all individuals with PNES 5 – 7 . However, the upper ranges of the estimates for a positive family history of psychiatric disorders and epilepsy are driven by the inclusion of individuals with PNES and comorbid epilepsy.…”

Psychogenic Nonepileptic Seizures in Men: Comparison of Clinical and Psychosocial Features between Afro-American and Caucasian Patients

“…The higher incidence of limp/unresponsive activity in Caucasian males is concordant with low reported history of abuse. Of course this is in contrast to the female population where sexual abuse is frequently reported in studies of PNES [18]. The absence of reported sexual abuse in our study could well be due to under reporting.…”

Psychogenic nonepileptic seizures: Should we use response to AEDS as a red flag for the diagnosis?

“…11 In the current study, the patients who experienced PNES remission had a mean diagnostic delay of 10.6 years, and the other patients had a mean delay of 5.6 years. These findings demonstrate the clinical effect of this placebo effect on diagnosis.…”