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Psychogenic non-epileptic seizures in an Irish tertiary referral centre for epilepsy

Published online by Cambridge University Press:  13 June 2014

Finian M O'Brien ,
Norman Delanty ,
Catherine Dineen  and
Kieran C Murphy
Finian M O'Brien*
Affiliation:
Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
Norman Delanty
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
Catherine Dineen
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
Kieran C Murphy
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
*
*Correspondence E-mail: [email protected]
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Abstract

Objectives: To examine the prevalence, psychiatric co-morbidity and management of psychogenic non-epileptic seizures (PNES) in patients admitted to a tertiary referral Epilepsy Monitoring Unit (EMU).

Methods: Medical records of patients admitted to the EMU between 2003 and 2005 were examined and data from neurological, neuropsychiatric and neuropsychological assessments were analysed.

Results: Over a three year period 224 patients were referred to the EMU and 44 (20%) were diagnosed with psychogenic non-epileptic seizures (PNES). A total of 13 people (6%) were diagnosed with both PNES and epilepsy. Of those diagnosed with PNES 34 (75%) were referred to psychology services for cognitive behavioural therapy (CBT) and 26 (58%) were followed-up by psychiatry services.

Conclusions: The prevalence rates for PNES and co-existing PNES and epilepsy are consistent with previous reports. Rates of psychiatric co-morbidity were less than would be expected in this clinical population. Clear evidence-based guidelines to manage people with PNES are required.

Keywords

PsychogenicNon-epileptic convulsionsConversion disorderPrevalenceEpilepsy
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 26 , Issue 4 , December 2009 , pp. 174 - 178
Copyright
Copyright © Cambridge University Press 2009

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References

1.Walker, MC, Howard, RS, Smith, SJ. Diagnosis and treatment of status epilepticus on a neurological intensive care unit. QJM 1996; 89: 913–20.CrossRefGoogle ScholarPubMed
2.Gates, JR. Part summary: neurologic aspects of non-epileptic seizures in the adult and pediatric patient. In: Gates, JR, Rowan, AJ (eds). Non-epileptic seizures. 2nd ed. Boston: Butterworth-Heineman 2000: 111–112.Google Scholar
3.Reuber, M. Psychogenic nonepiieptic seizures: diagnosis, etiology and prognosis. Schweiz Arch Neurol Psychiatr 2005; 156: 47–57.Google Scholar
4.World Health Organisation. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research, Geneva, Switzerland: WHO, 1993.Google Scholar
5.Benbadis, SR, Agrawal, V, Tatum, WO. 4th. How many patients with psychogenic nonepiieptic seizures also have epilepsy? Neurology 2001; 57: 915–917.CrossRefGoogle Scholar
6.Martin, R, Burneo, JG, Prasad, Aet al. Frequency of epilepsy in patients with psychogenic seizures monitored by video-EEG. Neurology 2003; 61: 1791–1792.CrossRefGoogle ScholarPubMed
7.Alsaadi, TM, Marquez, AV. Psychogenic Nonepiieptic seizures. Am Fam Physician 2005; 72(5): 849–856.Google ScholarPubMed
8.Krahn, LE, Reese, MM, Rummans, TA, Peterson, GC, Suman, V, Sharbrough, FW. Health utilization of patients with psychogenic nonepiieptic seizures. Psychosomatics 1997; 38: 535–42.CrossRefGoogle ScholarPubMed
9.Martin, R, Bell, B, Hermann, B, Mennemeyer, S. Nonepiieptic seizures and their costs: the role of neuropsychology. In: Prigatano, GP, Pliskin, NH, eds. Clin Neuropsychology and Cost Outcome Research: A Beginning. New York: Psychology Press, 2003: 235–58.Google Scholar
10.Martin, RC, Gilliam, FG, Kilgore, M, Faught, E, Kuzniecky, R. Improved health care resource utilization following video-EEG-confirmed diagnosis of nonepileptic psychogenic seizures. Seizure 1998; 7: 385–90CrossRefGoogle ScholarPubMed
11.O'Sullivan, SS, Spillane, JE, McMahon, EMet al.Clinical characteristics and outcome of patients diagnosed with psychogenic nonepileptic seizures: A 5-year review. Epilepsy Behav 2007; 11(1): 77–84.CrossRefGoogle ScholarPubMed
12.Pallant, J. SPSS survival manual: A step by step guide to data analysis using SPSS for Windows Version 11. Buckingham: Open University Press, Maidenhead, UK, 2001.Google Scholar
13.Sigurdardottir, KR, Olafsson, E. Incidence of psychogenic seizures in adults: a population-based study in Iceland. Epilepsia 1998; 39: 749–752.CrossRefGoogle ScholarPubMed
14.Howell, SJ, Owen, L, Chadwick, DW. Pseudostatus epilepticus CUM 1989; 71: 507–519.Google ScholarPubMed
15.Carton, S, Thompson, PJ, Duncun, JS. Non-epileptic seizures: patients' understanding and reaction to the diagnosis and impact on outcome. Seizure 2003; 12(5): 287–94.CrossRefGoogle Scholar
16.Mellers, JDC. The approach to patients with ‘non-epileptic seizures’. Postgrad Med J 2005; 81: 498–504.CrossRefGoogle ScholarPubMed
17.Aboukasm, A, Mahr, G, Gahry, BR, Thomas, A, Barkley, GL. Retrospective analysis of the effects of psychotherapeutic interventions on outcomes of psychogenic nonepileptic seizures. Epilepsia 1998; 39(5): 470–473.CrossRefGoogle ScholarPubMed
18.Bowman, ES, Markand, ON. Psychodynamics and psychiatric diagnoses of pseudoseizure subjects. Am J Psychiatr 1996; 153: 57–63.Google ScholarPubMed
19.Bowman, ES. Psychopathology and outcome in pseudoseizures. In: Ettinger, AB, Kanner, AM (eds). Psychiatric issues in epilepsy: a practical guide to diagnosis and treatment. Philadelphia: Lippincott Williams & Wilkins, 2001: 355–377.Google Scholar
20.Brooks, JL, Baker, GA, Goodfellow, L, Bodde, N, Aldenkamp, A. Behavioural treatments for non-epileptic attack disorder. Cochrane Database of Systematic Reviews 2007;lssue 1: Art. No.: CD006370. DOI: 10.1002/14651858.CD006370.CrossRefGoogle Scholar
21.Stone, J, Binzer, M, Sharpe, M. Illness beliefs, and locus of control in pseudoseizures. J Psychosomatic Res 2004; 57: 541–547.CrossRefGoogle ScholarPubMed
22.Reuber, M, Pukrop, R, Bauer, J, Helmstaedter, C, Tessendorf, N, Elger, CE. Outcome in psychogenic nonepileptic seizures: 1 to 10-year follow-up in 164 patients. Ann Neurol 2003; 53: 305–11.CrossRefGoogle ScholarPubMed
23.Reuber, M, Elger, CE. Psychogenic nonepileptic seizures: review and update. Epilepsy and Behavior 2003; 4: 205–216.CrossRefGoogle ScholarPubMed
24.National Institute for Clinical Excellence. The Epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care. NICE Clinical Guideline 20 2004; October: 57.Google Scholar