Usefulness of a new semiological classification for characterizing psychogenic nonepileptic seizures

被引:0
作者
Ingrid Rosso, Barbara [1 ]
Carlos Avalos, Juan [1 ]
Gabriela Besocke, Ana [1 ]
del Carmen Garcia, Maria [1 ]
机构
[1] Hosp Italiano Buenos Aires, Buenos Aires, DF, Argentina
关键词
Stress; Psychological; Seizures; Diagnosis; VALIDATION;
D O I
10.1590/0004-282X-ANP-2019-0171
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: Nonepileptic events misdiagnosed as epilepsy lead to a risk of iatrogenic morbidity, which increases health costs. Among the patients affected by nonepileptic events, 11-46% are psychogenic nonepileptic seizures (PNESs). Objective: To investigate the usefulness of the semiological classification of PNESs among patients diagnosed by means of video electroencephalograms (vEEGs). Methods: This was a retrospective review of the medical records of patients admitted to the adult vEEG unit between April 2007 and December 2016, who were diagnosed with PNES that was confirmed through vEEG. Analysis on demographic and clinical data and classification of PNESs according to the Magaudda classification were performed. Results: We identified 143 patients, among whom 31.5% had also epilepsy. According to the Magaudda classification, the events were: hypermotor (58%); subjective symptoms (21.7%); akinetic (14.7%) and focal motor (5.6%). Hypermotor predominated in both genders, followed by subjective symptoms in women (23.9%) and akinetic in men (19.2%). The mean number of antiepileptic drugs (AEDs) prescribed per patient was 2.3. Thirty-two patients (22.4%) required at least one hospitalization for PNESs. 48.3% of the patients had psychiatric comorbidities. Conclusion: The proposed semiological classification of PNESs is a relevant tool that general neurologists can use to characterize these events in their daily practice. Correct use of this classification, together with vEEG and appropriate clinical suspicion, makes it possible to reach an accurate early diagnosis, thus reducing morbidity and, possibly, the high costs associated with PNESs
引用
收藏
页码:278 / 282
页数:5
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