Dec 4, 2020

Sexual Assault Trauma May Partly Explain Why Women More Likely to Develop Psychogenic Nonepileptic Seizures, Large Study Shows

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Press Release

Friday, Dec. 4, 2020
9 a.m. EST
Abstract 912514

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.”


Davis Renzelmann
Public Communications Inc.

About the American Epilepsy Society

Founded in 1936, the American Epilepsy Society (AES) is a medical and scientific society whose members are dedicated to advancing research and education for preventing, treating and curing epilepsy. AES is an inclusive global forum where professionals from academia, private practice, not-for-profit, government and industry can learn, share and grow to eradicate epilepsy and its consequences.