EMBARGOED FOR RELEASE:
Friday, Dec. 4, 2020
9 a.m. EST
CHICAGO – Women are more likely than men to develop psychogenic nonepileptic seizures
(PNES), in many cases as a result of sexual assault trauma, suggests a large study being
presented virtually at American Epilepsy Society AES2020.
Unlike epilepsy, which is triggered by a neurological cause, PNES is a condition in which a
person’s seizures may be due to a psychological cause. While small studies have suggested a
connection between PNES and sexual assault trauma, researchers for this study used an
automated algorithm to assess electronic health records and identify PNES patients on a much
larger scale, finding a very strong association between the condition and sexual assault
trauma. It was also the first study to identify a connection between PNES and stroke.
The analysis of more than 2.3 million patients treated at one health system between October
1989 and October 2018 found 3,341 adults had been diagnosed with PNES. Nearly threequarters of patients with PNES were women and they were significantly more likely to report
sexual assault trauma than men.
“Since we know sexual assault is more common in women, we wanted to explore whether
exposure to this trauma could in part explain why they are more likely to experience PNES.
We determined that sexual assault trauma accounted for 22% of the increased risk of PNES in
women compared to men,” said Slavina Goleva, B.S., Ph.D. candidate at Vanderbilt
University, Nashville, and lead author of the study. “We found that overall, people who had
PNES were 15 times more likely than the general hospital population to have experienced and
disclosed sexual assault trauma to their health care providers.”
Researchers also determined people diagnosed with PNES were 8% more likely than the
general hospital population to have suffered a stroke. Among the 92 patients who had both
PNES and stroke, 48% experienced a stroke and then were diagnosed with PNES, 29% were
diagnosed with PNES before the stroke and 23% were diagnosed with both at about the same
time. The researchers note that the reason for the association is not clear and needs to be
explored further in a larger study.
People with PNES don’t have abnormal brain wave patterns leading to seizures as do people
with epilepsy. Experts believe psychological stress such as posttraumatic stress
disorder, anxiety, depression and personality disorders may cause seizures.
Anti-seizure medications are not effective for people who have PNES, but
medications that treat the underlying mental health conditions that can
contribute to triggering these seizures may be helpful.
“These results identify stroke as a possible predictor for PNES and reinforce that people who
are experiencing seizures and have psychiatric risk factors should be referred for video-EEG
monitoring to diagnose whether they are experiencing epileptic seizures or nonepileptic
seizures,” said Kevin Haas, M.D., Ph.D., coauthor of the study and associate professor of
neurology at Vanderbilt. “Early diagnosis for patients with PNES is critical, allowing them to
begin an appropriate treatment plan while avoiding misdiagnosis with epilepsy and the
dangers of inappropriate treatments.”