Background Psychogenic non-epileptic seizures (PNES) are often seen as indicators of poor motor and sensory function caused by psychological responses to stressful experiences. A seizure might trigger these reactions. The aim of our study was to assess the structural changes in brain MRI associated with psychogenic non-epileptic seizures. Methodology A retrospective analytical cross-sectional study at the Department of Medicine and Neurology, Ayub Teaching Hospital, Abbottabad, was conducted from October 2020 to September 2021. The medical records of patients with confirmed PNES were collected and retrospectively evaluated. Results Medical records and MRI scans were accessible for 52 patients with PNES; 10 patients were excluded from the study. The average age of the patients (standard deviation) was 34 (±9) years, and the average age at onset was 31.6 (±5.8) years. Based on the video-EEG recordings, 57.1% of patients (n=24) were classified as having broadly generalized motor seizures, 40% of patients (n=17) were classified as having predominantly akinetic seizures defined primarily by blank spells, and only one patient was classified as having focal motor seizures. Only three patients (7%) had a positive epilepsy family history. Twenty-four (47.6%) patients with brain MRI scans reported abnormal findings, while 22 (52.4%) had normal MRI findings. The majority of patients with abnormal MRIs had nonspecific white matter changes (50%), mesial temporal sclerosis (15%), and cysts (15%). In a statistical analysis, age at the beginning of PNES (p = 0.04), duration of PNES (p=0.01), concomitant epilepsy (p = 0.05), generalized motor seizures (p= 0.03), and focal motor seizures (p= 0.02) were strongly associated with abnormal brain MRI findings. Conclusion Research reveals that persons with PNES have a higher-than-average prevalence of anatomical brain abnormalities. The main takeaway is that these findings lend credence to the growing body of data suggesting that PNES may not be a medical mystery but rather a disorder with physical foundations in the brain. Important implications for diagnosing and treating PNES patients are discussed, as are the outcomes of earlier neuroimaging investigations of PNES. Studying the involvement of structural brain anomalies in the etiology of psychogenic non-epileptic seizures requires further well-designed multicenter studies with larger sample sizes and a consistent imaging approach (PNES). It is crucial to consider any confounding variables, such as co-occurring mental diseases, while designing this study.
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http://dx.doi.org/10.7759/cureus.32144 | DOI Listing |
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 PDFEpilepsy Behav
December 2024
Liv Hospital Neurology Department, Kavaklıdere, Bestekar Cd No:8, 06680 Cankaya, Ankara, Turkey.
Objective: Numerous studies have been conducted investigating the effects of antiseizure medications (ASMs) on cognitive functions, and the cognitive side effects of some ASMs have been demonstrated. However, data on whether tolerance to these side effects develops over time is insufficient. The aim of this study is to evaluate the reversibility of cognitive impairments caused by ASMs in patients, utilizing event-related potentials (ERPs) and the Montreal Cognitive Assessment (MoCA) test.
View Article and Find Full Text PDFEpilepsia 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 PDFEpilepsy Behav
December 2024
University Hospitals, Cleveland Medical Center, Department of Neurology, 11100 Euclid Ave., Cleveland, OH 44106; Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106.
Patients with psychogenic non-epileptic attacks (PNEA) are subject to considerable direct and indirect comorbid psycho-socio-economic impact from their condition. Fortunately, diagnosis and treatment of PNEA has shown to be both medically effective and cost-efficient, ultimately improving PNEA symptoms, mental health, quality of life, and healthcare resource utilization. Though provocation techniques for PNEA have proven highly effective in diagnosing and providing expedited treatment to these patients, they have recently begun to fall out of favor due to ethical concerns about their use.
View Article and Find Full Text PDFNeuropsychiatr Dis Treat
November 2024
Department of Psychiatry, International Centre for Healthcare and Medical Education (ICHME), London, UK.
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