TY - JOUR
T1 - Evidence of brain abnormality in patients with psychogenic nonepileptic seizures
AU - Reuber, M.
AU - Fernández, G.
AU - Helmstaedter, C.
AU - Qurishi, A.
AU - Elger, C. E.
N1 - Funding Information:
Markus Reuber was supported by the St. James's Nervous Diseases Research Trust and the Special Trustees of the General Infirmary at Leeds, Leeds, Great Britain.
PY - 2002/6
Y1 - 2002/6
N2 - Markers of brain abnormalities in patients with psychogenic nonepileptic seizures (PNES) were studied to explore whether physical brain disorder is associated with an increased risk of PNES. Evidence of epileptiform EEG changes, MRI abnormalities, and neuropsychological (NPS) deficits was obtained from the records of 329 consecutive patients in whom the diagnosis of PNES was established at our center between 1991 and 2001. Two hundred six patients had PNES alone, and 123 PNES and epilepsy (PNES + E). In the PNES-only group, at least one marker of brain disorder was detected in 22.3% of patients (epileptiform potentials in 8.7%, MRI changes in 9.7%, NPS deficits in 9.7%). The actual prevalence of abnormalities is likely to be higher because 54.9% of the patients with only psychogenic seizures did not undergo MRI or neuropsychological testing. Evidence of brain abnormality was found more frequently in the PNES + E group (epileptiform potentials in 70.7%, MRI changes in 60.2%, NPS deficits in 52.8%). Although markers of brain abnormality were detected much less commonly in the PNES than in the PNES + E group, they were still found in a substantial proportion of patients with PNES alone. This suggests that physical brain disease plays a role in the development of PNES. Markers of physical abnormality were not more common in the right hemisphere.
AB - Markers of brain abnormalities in patients with psychogenic nonepileptic seizures (PNES) were studied to explore whether physical brain disorder is associated with an increased risk of PNES. Evidence of epileptiform EEG changes, MRI abnormalities, and neuropsychological (NPS) deficits was obtained from the records of 329 consecutive patients in whom the diagnosis of PNES was established at our center between 1991 and 2001. Two hundred six patients had PNES alone, and 123 PNES and epilepsy (PNES + E). In the PNES-only group, at least one marker of brain disorder was detected in 22.3% of patients (epileptiform potentials in 8.7%, MRI changes in 9.7%, NPS deficits in 9.7%). The actual prevalence of abnormalities is likely to be higher because 54.9% of the patients with only psychogenic seizures did not undergo MRI or neuropsychological testing. Evidence of brain abnormality was found more frequently in the PNES + E group (epileptiform potentials in 70.7%, MRI changes in 60.2%, NPS deficits in 52.8%). Although markers of brain abnormality were detected much less commonly in the PNES than in the PNES + E group, they were still found in a substantial proportion of patients with PNES alone. This suggests that physical brain disease plays a role in the development of PNES. Markers of physical abnormality were not more common in the right hemisphere.
KW - Conversion disorder
KW - Dissociative seizures
KW - Electroencephalography
KW - Epilepsy
KW - Magnetic resonance imaging
KW - Neuropsychological tests
KW - Pseudoseizures
KW - Psychogenic nonepileptic seizures
KW - Somatoform disorder
UR - https://www.scopus.com/pages/publications/0036623559
U2 - 10.1016/S1525-5050(02)00004-5
DO - 10.1016/S1525-5050(02)00004-5
M3 - Article
AN - SCOPUS:0036623559
SN - 1525-5050
VL - 3
SP - 249
EP - 254
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
IS - 3
ER -