Literature Review

Self-Reported Allergies May Separate Psychogenic Seizures from Epilepsy

Patients who complain about undocumented allergic reactions are more likely to experience psychogenic nonepileptic seizures


To distinguish between psychogenic nonepileptic seizures (PNES) and epilepsy, clinicians may want to find out how often their patients self-report allergies, according to a recent analysis of patient records. The researchers found 905 cases of PNES and 5187 controls who had epilepsy but not PNES. When they compared electronic medical records and ICD-9 codes, and used text-identification algorithms to search EEG reports, they found that patients with PNES were significantly more likely to report allergies than did patients who only had epilepsy (mean 1.93 vs 1.00, P<.001). Each self-report of an allergy increased the association with PNES by 2.98%; in patients reporting 12 or more allergies, 48.2% had PNES, compared to 11.6% in patients reporting no allergies (odds ratio: 6.49). The researchers used self-reported allergies as a marker suggesting psychogenic seizures because they theorized that such concerns may reflect somatization.

Robbins NM, Larimer P, Bourgeois JA, Lowenstein DH. Number of patient-reported allergies helps distinguish epilepsy from psychogenic nonepileptic seizures. Epilepsy Behav. 2016;55:174-177.

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