A spell in the epilepsy clinic and a history of "chronic pain" or "fibromyalgia" independently predict a diagnosis of psychogenic seizures

Epilepsy Behav. 2005 Mar;6(2):264-5. doi: 10.1016/j.yebeh.2004.12.007.

Abstract

The clinical suspicion for psychogenic nonepileptic seizures (PNES) is based on multiple features obtained in the history. We reviewed the records of all patients evaluated over 5 years in a single epilepsy clinic for refractory seizures who eventually underwent EEG/video monitoring. We designated two groups: (1) patients with a diagnosis of "fibromyalgia" or "chronic pain" and (2) patients who had a seizure during the visit, either in the waiting area or in the examining room. Of 36 patients with "fibromyalgia" or "chronic pain," 27 (75%) were found to have PNES. Of 13 patients who had a "seizure" during their clinic visit, 10 (75%) were found to have PNES. We conclude that each of these findings has a predictive value of 75%.

MeSH terms

  • Diagnosis, Differential
  • Electroencephalography / methods
  • Fibromyalgia / diagnosis*
  • Fibromyalgia / physiopathology
  • Humans
  • Longitudinal Studies
  • Medical History Taking
  • Pain / diagnosis*
  • Pain / physiopathology
  • Psychophysiologic Disorders / diagnosis*
  • Psychophysiologic Disorders / psychology
  • Seizures / diagnosis*
  • Seizures / psychology*
  • Video Recording