Natural history of patients with psychogenic nonepileptic seizures

Purpose: The purpose of this study was to investigate the long-term outcome of patients with psychogenic nonepileptic seizures (PNES), who never visited a psychologist and never received a proper therapy for their condition (due to lack of resources). We also aimed to investigate factors potentially associated with the outcome in these patients. Methods: We studied all patients with PNES, who were admitted to the epilepsy monitoring unit at the Shiraz Comprehensive Epilepsy Center, from 2008 until 2013. In a phone call interview to the patients in November and December 2018, we obtained the following information: seizure outcome, history of receiving any psychotherapy after confirming their diagnosis at referral, and finally, their current marital status, education, and employment status. Results: 69 patients had the inclusion criteria. Thirty-six patients (52%) were seizure-free during the past 12 months, but 33 (48%) still suffer from seizures. The only variable (at diagnosis), which was significantly associated with their outcome, was duration of their condition before they received a definite diagnosis. Conclusion: More than half of the patients with untreated PNES may become free of seizures after they receive a definite diagnosis and with the passage of time. Longer duration of PNES before the patients received a definite diagnosis may affect their long-term outcome.