Comparative study of differential seizure semiology and psychiatric disorders prevalence between psychogenic non-epileptic seizures and temporal lobe epileptic seizures

SCÉVOLA L , LOMBARDI NR, ALONSO N, GARGIULO Á, FERNANDEZ LIMA M, GIAGANTE B , PEREIRA N, KORMAN G, ODDO S, KOCHEN S, D'ALESSIO L

Barcelona

Congreso; 32nd International Epilepsy Congress; 2017

International League Against Epilepsy

Introduction: Psychogenic non-epileptic seizures (PNES) are diagnosed when disruptive changes in behavior, thinking or emotion, that resemble epileptic seizures (ES), are present without an ictal correlate of epileptogenic brain activity. Psychiatrically, PNES represent an underlying psychiatric disorder, usually defined as conversive and/or dissociative disorder. The aim of this study was to determine VEEG differential seizure semiology, and psychiatric disorder prevalence, between psychogenic non-epileptic seizures and temporal lobe epileptic seizures. Method: VEEG reports of patients consecutively admitted from 2009 to 2015 were reviewed. All seizures recorded were analyzed and classified according to the presence of: aura, total lack of responsiveness, hypermotor, automatisms and immobility. All patients completed a psychiatric evaluation during VEEG monitoring (SCID I and II of DSM IV). Student t test, Chi Square and binary logistic regression were determined for statistical analysis. All Patients had a psychiatric evaluation (SCID I y II del DSM IV). Results: 32 patients with PNES (32 ±11 years) and 34 with TLE (32 ±12 years) were included. Female patients were predominant in PNES group (p< 0.05). The total of lack of responsiveness (OR= 24.4 CI 95% 3.79-157.3) and the presence of automatisms (OR= 13.9 CI 95% 2.1-90.5) were found as positive predictors for detecting TLE comparing PNES (p< 0.01). Regarding psychiatric diagnoses the presence of post-traumatic stress disorder and depression, were more frequent among PNES (p< 0.01). Conclusion: In this preliminary study we found differences that may orientate the differential diagnosis between PNES and TLE and accelerate VEEG in PNES patients.