Long-term outcome in a sample of underprivileged patients with psychogenic nonepileptic seizures (PNES) living in Argentina

Epilepsy Behav. 2019 May;94:183-188. doi: 10.1016/j.yebeh.2019.03.005. Epub 2019 Apr 6.

Abstract

Objective: The objective of the present study was to perform a long-term follow-up of economically disadvantaged Latin American patients diagnosed as having psychogenic nonepileptic seizures (PNES) and contribute to the field's understanding of outcome in this population.

Background: A handful of studies have examined outcome of patients once the diagnosis of PNES has been communicated. However, the vast majority of these have been conducted in the first world countries with samples that were predominantly Caucasian. There is limited knowledge about outcome in economically disadvantaged Latin American patients diagnosed as having PNES.

Methods: This is a study of 23 patients (20 women, 3 men) with PNES in which demographic data (age, education, nationality, presence of psychological trauma, age of onset) were retrospectively retrieved from medical files. Follow-up was done through a telephonic questionnaire in which investigators collected clinical information (seizure characteristics at follow-up, and treatments employed) and changes in demographic data.

Results: Patients from this Argentinian PNES sample demonstrated having many similar demographic and clinical characteristics to samples from US and European studies. Long-term follow-up revealed, however, decreased seizure frequency and intensity as well as a substantial improvement in occupational status. A majority had engaged in psychotherapy as well as alternative and complementary approaches. A majority had also developed what are suspected to be other functional symptoms.

Conclusions: Argentinian patients from economically disadvantaged backgrounds, diagnosed as having PNES reported improvements in seizure frequency and occupational status during long-term follow-up. Future studies will need to focus on what (e.g., communication of diagnosis, psychotherapy, alternative treatments) may have contributed to these changes.

Keywords: Follow-up; Functional neurological; Hispanic; Latino; Outcome; Psychogenic nonepileptic seizures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Age of Onset
  • Argentina / epidemiology
  • Employment
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Poverty / statistics & numerical data*
  • Psychotherapy
  • Retrospective Studies
  • Seizures / epidemiology
  • Seizures / psychology
  • Seizures / therapy*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vulnerable Populations