Differentiating PNES from epileptic seizures using conversational analysis

Epilepsy Behav. 2017 Nov;76:46-50. doi: 10.1016/j.yebeh.2017.08.034. Epub 2017 Sep 15.

Abstract

We applied conversation analysis in an unselected continuous series of 70 patients to discriminate patients with psychogenic nonepileptic seizures (PNES) from patients with epilepsy. Two psychologists examined the patients' recorded reports. Patients were also submitted to an extensive neuropsychological battery in order to verify whether specific cognitive deficits or mental health problems are typical of patients with PNES and whether some cognitive deficits could prevent the correct diagnosis. The results showed a good percentage of correct diagnosis, with a sensitivity of 0.795 and a specificity of 0.83, while no difference in the cognitive profile was found between patients with PNES and patients with epilepsy. The results also suggest that psychologists can apply the conversation analysis as well as linguists, which is an important finding since psychologists are employed in specialized centers, while linguists in general are not part of the team.

Keywords: Conversation analysis; Psychogenic nonepileptic seizure; Video-EEG.

MeSH terms

  • Adult
  • Aged
  • Diagnosis, Differential
  • Electroencephalography / methods*
  • Epilepsy / diagnosis*
  • Epilepsy / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychophysiologic Disorders / diagnosis*
  • Psychophysiologic Disorders / psychology
  • Seizures / classification
  • Seizures / diagnosis*
  • Seizures / psychology
  • Sensitivity and Specificity