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Psychogenic, Non-Epileptic Seizure Screening Aids

Epilepsia; ePub 2017 Sep 12; Kerr, Janio, et al

An accurate patient-reported medical history and medication history can be useful when screening for possible psychogenic non-epileptic seizures (PNES), according to a recent study. Based on data from 1,365 adult patients with video-electroencephalography-confirmed diagnoses from a single center, researchers compared the total number of comorbidities, number of medications, and presence of specific comorbidities in 5 mutually exclusive groups of diagnoses: epileptic seizures (ES) only, PNES only, mixed PNES and ES, physiologic non-epileptic seizure-like events, and inconclusive monitoring. They found:

  • PNES only was differentiated from ES only with a prospective accuracy of 78% and area under the curve of 79%.
  • With a few exceptions, the number of comorbidities and medications was more predictive than a specific comorbidity.
  • Comorbidities associated with PNES were asthma, chronic pain, and migraines.
  • Comorbidities associated with ES were diabetes mellitus and non-metastatic neoplasm.
  • The population-level analysis suggested that patients with mixed PNES and ES may be a population distinct from patients with either condition alone.
Citation:

Kerr WT, Janio EA, Braesch CT, et al. Identifying psychogenic seizures through comorbidities and medication history. [Published online ahead of print September 12, 2017]. Epilepsia. doi:10.1111/epi.13888.

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