Clinical Features and Prognosis of Non-Epileptic Seizures in a Developing Country

SILVA WALTER; GIAGANTE BRENDA; SAIZAR ROBERTO; D'ALESSIO LUCIANA; ODDO SILVIA; CONSALVO DAMIÁN; SAIDÓN PATRICIA; KOCHEN SILVIA

EPILEPSIA

Año: 2001 vol. 42 p. 398 - 401

0013-9580

Purpose: To determine the predictive value of clinical features and medical history in patients with non-epileptic seizures (NESs). Methods: One hundred sixty-one consecutive ictal video-EEGs were reviewed. and 17 patients with 41 NESs identified. NES diagnosis was defined as paroxysmal behavioral changes suggestive of epileptic seizures recorded during video-EEG without any electrographic ictal activity. Clinical features, age, sex, coexisting epilepsy, associated psychiatric disorder, social and economic factors, delay in reaching the diagnosis of NES. previous treatment, and correlation with outcome on follow-up were examined. Results: The study population included 70% female patients with a mean age of 33 years. Mean duration of NES before diagnosis was 9 years. Forty-one percent had coexisting epilepsy. The most frequent NES clinical features were: tonic-clonic mimicking movements and fear/anxiety hyperventilation. The most common psychiatric diagnosis was conversion disorder and dependent and borderline personality disorder. Seventy-three percent of patients with pure NESs received antiepileptic drugs (AEDs), and 63.5% of this group received new AEDs. Fifty-nine percent of the patients received psychological/psychiatric therapy. At follow-up, 23.5% were free of NESs.      .. Conclusions: AlI seizure-free patients had two-good prognostic factors: having an independent lifestyle and the acceptance of the nonepileptic nature of the episodes. Video­EEG monitoring continues to be the-diagnostic method to ensure accurate seizure classification. Establishing adequate health care programs to facilitate access to new technology in public hospitals as well as the implementation of continuous education programs for general practitioners and neurologists could eventually improve the diagnosis and treatment of patients with NESs