Rationale:
Psychogenic non-epileptic seizures (PNES) are paroxysmal events that mimic epileptic seizures but without ictal EEG abnormalities, falling under Functional Neurological Symptom Disorder (Conversion Disorder) [1]. Emotional dysregulation suggests episodes relieve distress via primary gain [2,3]. No studies have quantified such relief. We aimed to determine the prevalence and characterize post-episode relief in adult PNES outpatients.Methods:
Twenty-six video-EEG–confirmed PNES outpatients (mean age 46 ± 15 years; 24 F, 2 M) completed a two-item relief questionnaire and provided age, sex, and seizure frequency. Relief prevalence (95 % CI), relief-type distribution, mean age differences (two-sample t-test), and associations with sex and frequency (Fisher’s exact test) were calculated.
Results:
Ten of 26 patients (38.5 %; 95 % CI 22.4–57.5 %) reported relief—eight (80 %) mental, one (10 %) physical, and one (10 %) both. Sixteen (61.5 %) did not experience relief. Mean age was similar (relief vs. no-relief: 45.0 ± 15.7 vs. 47.6 ± 16.1 years; p = 0.69). Relief prevalence did not differ by sex (p = 1.00) or seizure frequency (OR 0.61; 95 % CI 0.09–3.94; p = 0.69).
Conclusions:
In this pilot study, 38.5% of PNES patients reported immediate mental relief, supporting PNES as affect-regulation.61.5%of PNES patients did not experience relief, indicating heterogeneity in post‐episode responses that may differ in underlying mechanisms or treatment needs. Larger, multi-center studies with standardized emotion, trauma measures and multivariable analysis are needed to identify predictors. If validated, a single-item relief query could improve early PNES recognition, reduce unnecessary antiseizure medications, and facilitate timely referral for psychotherapy.
Funding: N/A