Purpose: Clinical observations suggest that psychogenic non-epileptic seizure (PNES) patients often have severe migraine, more severe than epilepsy patients. Investigations into migraine characteristics in patients with PNES are lacking. In this study we tested the hypothesis that, compared to epilepsy patients, PNES patients have more severe migraine, with more frequent and longer duration attacks that cause greater disability.
Method: In this observational study, 633 patients with video-EEG proven epilepsy or PNES were identified from the Mayo Clinic Epilepsy Monitoring Unit database. Contacted patients were screened for migraine via a validated questionnaire, and when present, data regarding migraine characteristics were collected. Two-sample t-tests, chi square analyses, and Mann-Whitney U tests were used to compare migraine characteristics in PNES patients to those of epilepsy patients.
Results: Data from 43 PNES patients with migraine and 29 epilepsy patients with migraine were available. Compared to epilepsy patients, PNES patients reported having more frequent headaches (mean 15.1 ± 9.8 vs. 8.1 ± 6.6 headache days/month, p<.001), more frequent migraine attacks (mean 6.5 ± 6.3 vs. 3.8. ± 4.1 migraines/month, p=.028), longer duration migraines (mean 39.5 ± 28.3 vs. 27.3 ± 20.1h, p=.035), and more frequently had non-visual migraine auras (78.6% vs. 46.7% of patients with migraine auras, p=.033). Migraine-related disability scores were not different between PNES and epilepsy patients (median 39, interquartile range 89 vs. 25, interquartile range 60.6, p=.15).
Conclusion: Compared to epilepsy patients with migraine, PNES patients with migraine report having a more severe form of migraine with more frequent and longer duration attacks that are more commonly associated with non-visual migraine auras.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.seizure.2015.12.006 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Evaluation of the relationships between psychiatric comorbidity and seizure semiology in psychogenic non-epileptic seizure patients.
Acta Psychol (Amst)
December 2024
İzmir Katip Çelebi University Atatürk Research and Training Hospital, Department of Neurology, Basınsitesi, 35150 Karabağlar, İzmir, Turkey.
Psychogenic non-epileptic seizures (PNES) are episodic events that bear a resemblance to epileptic seizures (ES) in their outward manifestations, yet they lack pathological electroencephalographic (EEG) activity during the ictal phase. In the Diagnostic and Statistical Manual 5th Edition (DSM-5), PNES is designated as "Functional Neurological Symptom Disorder with seizures". Individuals diagnosed with PNES commonly present with concurrent psychiatric disorders, notably depression, panic disorder, and chronic anxiety.
View Article and Find Full Text PDFMRI findings in patients with psychogenic non-epileptic seizures: Prevalence, distribution, and classification of the findings. A single tertiary epilepsy center experience.
Epilepsia Open
December 2024
Radiology Department, Hospital Clinic of Barcelona, Barcelona, Spain.
Objective: Psychogenic non-epileptic seizures (PNES) mimic epileptic seizures without electroencephalographic correlation. Although classified as psychiatric disorders, their neurobiological or structural basis remains unclear. This study aimed to assess the prevalence and characteristics of MRI abnormalities in patients with PNES and those with comorbid epilepsy, compared to the general population, to enhance radiological evaluation and management.
View Article and Find Full Text PDFPsychiatric Comorbidities in Functional Neurological Disorders and Psychogenic Non-Epileptic Seizures: A Systematic Review and Policy Recommendations for Improving Assessment and Treatment.
Neuropsychiatr Dis Treat
November 2024
Department of Psychiatry, International Centre for Healthcare and Medical Education (ICHME), London, UK.
Article Synopsis
- PNES (Psychogenic Non-Epileptic Seizures) and FND (Functional Neurological Disorders) are gaining attention from healthcare professionals, highlighting their complexity and comorbidity with psychiatric conditions.
- The systematic review shows that PNES and FND often occur alongside disorders like autism, BPD, PTSD, and are frequently linked to histories of trauma and neglect.
- The findings suggest a biopsychosocial model where early life experiences contribute to the development of these conditions, particularly in young female patients, and call for improved assessment and treatment strategies.
The Multidisciplinary Team in the Treatment of Patients With Epilepsy.
Epilepsy Curr
April 2024
VA Portland Healthcare System, Portland OR, USA.
Article Synopsis
- Optimal care for people with epilepsy involves a team of various health professionals, inspired by approaches in oncology.
- The article highlights the contributions of advanced practice providers, dieticians, psychologists, pharmacists, psychiatrists, and social workers in collaboration with neurologists.
- It discusses training and licensing of these professionals, their clinical roles, and offers recommendations for improving multidisciplinary care for people with epilepsy.
Ask the Patient: Goals for Functional seizure treatment.
Epilepsy Behav
December 2024
Department of Neurology, University of Colorado, Aurora, CO, United States.
Treatment trials for functional seizure (FS) help improve functioning and reduce disability in affected individuals. Clinical trials have prioritized clinician-defined outcomes, but no studies have directly asked adults with FS what they hope to accomplish. This study examined patient-defined goals for treatment in a consecutive cohort of 826 adults with FS referred for outpatient treatment.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!