Abstracts

Rationale: This retrospective pilot study in people with nonepileptic seizures (PNES), epileptic seizures (PWE), or both types of seizures (PNES+PWE) evaluated whether the groups can be differentiated by use of a German clinical personality questionnaire (FPZ), which is routinely used in epilepsy and which originally had been designed for patients with CNS pathologies. Methods: Groups of 58 PNES, 207 PWE and 70 PNES+ were selected and evaluated on the basis of having answered a questionnaire on personality (FPZ) which assesses Neuroticism, Organic psycho syndrome, Intra/extra-version, and Addiction via 22 sub-scales with 98 questions. Subgroups had received neuropsychological testing and additional scales for depression (BDI, anxiety (SAS), and quality of life (German modified QOLIE-10) Results: All questionnaires indicated greater behavioural problems in PNES and PWE+ as compared to PWE. A profile with greater emotional lability and aspects of an organic psychosyndrome was indicated in PNES. PNES as compared to PNES+ showed a trend of more frequent somatisation, poor reward learning, impulsivity, and communication problems when compared to PNES+. Cluster analysis of the FPZ revealed 4 clusters, two being associated more with epilepsy, (Cl1. mild psycho-syndrome and depression, CL3. emotional stable and non-depressed), two being associated more with PNES (Cl2. strong neuroticism, psychosyndrome, and depression CL4. neuroticism and not depressed). Cognitive problems were indicated in each group with a non-significant trend to be poorest in PNES+. Conclusions: Patients with PNES and PNES+ share common behavioural features with increased neuroticism and behaviours reminding of a fronto-medial dysfunction. Cluster analysis identifies clinical subgroups which may turn out to have a different aetiology or prognosis. A study taking this as well as seizure semiology into consideration has been initiated.