Diagnosis, costs, and utilization for psychogenic non-epileptic seizures in a US health care setting

Psychosomatics. Jan-Feb 2013;54(1):28-34. doi: 10.1016/j.psym.2012.08.005. Epub 2012 Nov 27.


Background: Psychogenic non-epileptic seizures (PNES) pose a substantial burden to patients and the health care system, due to long diagnostic and treatment delays.

Methods: This study used medical chart notes from 103 patients to shed light on the diagnostic process. Electronic medical records and cost data from a US health system were also used to investigate costs and utilization for the 12-months before and after PNES diagnosis.

Results: The results show that accurate diagnosis was typically achieved via the use of multiple medical tests, including vEEG, magnetic resonance imaging (MRI), and computed tomography (CT) scans, as well as historical diagnostic and clinical information. In the year following PNES diagnosis, a decline in average visits (-1.45) and costs (-$1784) were observed. The largest cost savings were seen in neurology care and inpatient stays.

Conclusions: This study has implications for timely and accurate diagnosis of PNES, which may decrease the overall health care burden for individuals and the health care system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diagnostic Techniques, Neurological / economics
  • Female
  • Health Care Costs
  • Health Services / economics*
  • Health Services / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Seizures / diagnosis
  • Seizures / economics*
  • Seizures / psychology
  • Somatoform Disorders / diagnosis
  • Somatoform Disorders / economics*
  • Somatoform Disorders / psychology
  • United States
  • Young Adult