ARE THERE PHYSICAL RISK FACTORS FOR PSYCHOGENIC NONEPILEPTIC SEIZURES IN PATIENTS WITH EPILEPSY?
Abstract number :
2.097
Submission category :
Year :
2002
Submission ID :
73
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Markus Reuber, Christoph Helmstaedter, Guillen Fernandez, Guido Widman, Christian E. Elger. Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, United Kingdom; Department of Epileptology, University of Bonn, Bonn, Germany
RATIONALE: Patients with epilepsy may have additional psychogenic nonepileptic seizures (PNES). It has been suggested that PNES are more common in patients with epilepsy who are female, develop epilepsy later in life and who have right hemispheric brain lesions. This controlled study informs participants whether these or other physical parameters are risk factors for the development of additional PNES in patients with epilepsy.
METHODS: In this study, 119 consecutive patients with PNES and concurrent epilepsy and 119 consecutive patients with epilepsy alone were compared with regard to the variables sex, age at onset of epilepsy, epileptic seizure frequency, epilepsy type (focal/generalized), location and lateralization of epileptogenic zone, etiology of epilepsy, interictal epileptiform potentials, magnetic resonance imaging (MRI) abnormalities, neuropsychological (NPS) deficits and intelligence quotient (IQ).
RESULTS: The factors female sex (p[lt]0.001), abnormal visual memory (p=0.009), global NPS impairment (p=0.015), and low IQ category (p=0.008) were associated with a higher risk of PNES. Other variables did not differ between the groups.
CONCLUSIONS: In patients with epilepsy, female sex, non-dominant hemisphere or global neuropsychological underperformance and low IQ are associated with an increased risk of PNES. MRI changes, epileptiform EEG abnormalities and location of epileptogenic zone did not show a predilection for the right hemisphere. Onset of epilepsy did not affect PNES risk. Physical factors do not fully explain the occurrence of PNES in patients with epilepsy, additional psychological, personality and biographical factors are likely to play an important role.
[Supported by: St James[ssquote]s Hospital Nervous Diseases Trust Fund and of the Special Trustees of the General Infirmary at Leeds, United Kingdom (M Reuber)]