KOCHEN Sara Silvia
congresos y reuniones científicas
Video-EEG based study of differential semiology between psychogenic non-epileptic seizures and temporal lobe epileptic seizures
SCÉVOLA LAURA, LOMBARDI NICOLAS, ALONSO NICOLAS, GARGIULO ÁNGEL, FERNANDEZ LIMA MÓNICA, KORMAN GUIDO, ODDO SILVIA, KOCHEN SILVIA, DALESSIO LUCIANA.
Congreso; 29TH ECNP Vienna Congress; 2016
AbstractIntroductionPsychogenic 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. Other psychiatric factors like sexual abuse, trauma and posttraumatic stress disorder (PTSD) have also been involved in the pathogenesis of PNES.PNES accounts for approximately 20% of all intractable seizure disorders referred to epilepsy centers and both disorders may co- exist in the same patient. Diagnostic delay is reported between 7-11 years and implies unnecessary exposure to antiepileptic drugs and retards the appropriate treatment implementation. Video-EEG (VEEG) is the gold standard in PNES diagnosis but the differential semiology may accelerate VEEG access in patients with suspected PNES and or mixed PNES/epilepsy. The aim of this study was to determine VEEG differential semiology between psychogenic non-epileptic seizures and temporal lobe epileptic seizures (the most frequent subtype of epilepsy).MethodsVEEG 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). Psychogenic non-epileptic seizure diagnostic criteria were the presence of atypical paroxysmal behavioural episodes recorded by VEEG monitoring, without EEG ictal activity (at least one attack recorded). Epileptic seizures were diagnosed if at least one characteristic clinical event was recorded with simultaneous ictal EEG abnormalities localized in temporal lobe. In patients with mixed PNES/ epilepsy only PNES events were analyzed for this study. Student t test, Chi Square and binary logistic regression were determined for statistical analysis.Results32 patients with PNES (32 ±11 years) and 34 with TLE (32 ±12 years) were included. Female patients were predominant in PNES group (p