Probability of recording psychogenic nonepileptic seizures during long-term video EEG monitoring
Abstract number :
1.258
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2017
Submission ID :
340483
Source :
www.aesnet.org
Presentation date :
12/2/2017 5:02:24 PM
Published date :
Nov 20, 2017, 11:02 AM
Authors :
Hirotaka Iwaki, Tohoku University Graduate School of Medicine; Kazutaka Jin, Tohoku University Graduate School of Medicine; Mayu Fujikawa, Tohoku University Graduate School of Medicine; Yu Kitazawa, Tohoku University Graduate School of Medicine; Yosuke Ka
Rationale: Definite diagnosis of psychogenic nonepileptic seizure (PNES) requires detection of seizures by long-term video EEG monitoring (VEM). Clinical factors associated with PNES detection during VEM remain unclear. The probability of detecting PNESs during 4-day VEM was evaluated and clinical factors were identified for successful detection of PNESs. Methods: The present study included 87 patients with PNES (50 women, aged 13-67 years) and 625 patients with epilepsy (319 women, aged 12-76 years), who underwent 4-day VEM in our epilepsy monitoring unit from 2011 to 2017. Patients who fulfilled the criteria of probable or clinically established PNES based on LaFrance’s definition were diagnosed with PNES. Patients with neither PNES nor epilepsy and patients with both PNES and epilepsy were excluded. The probabilities of detecting PNESs and epileptic seizures were compared. Logistic regression analysis was performed to identify clinical factors for the successful recording of PNESs. Results: The probability of detecting PNESs was significantly lower than that of epileptic seizures (49.4% vs. 74.4%). Habitual seizures were detected during 4-day VEM in three-fourths of PNES patients with daily or weekly seizures, but in almost all epilepsy patients with daily or weekly seizures (daily: 75.0% vs. 100.0%, weekly: 77.8% vs. 95.3%). Logistic regression analysis revealed that higher seizure frequency (odds ratio [OR]: 5.5, p=0.001), maintained consciousness during seizures (OR: 27.2, p=0.001), full-scale intelligence quotient (IQ) of less than 70 (OR: 173.8, p=0.008), female sex (OR: 10.6, p=0.011), and younger age at PNES onset (OR: 0.9, p=0.024) were significantly associated with successful seizure recording of PNESs. In particular, 83.3% of PNES patients with IQ of less than 70 had habitual seizures during 4-day VEM. Conclusions: The five clinical factors for capture of habitual seizures in patients with PNES during 4-day VEM are higher seizure frequency, maintained consciousness during seizures, lower IQ, female sex, and younger age at PNES onset. Funding: None.
Cormorbidity