Improved health care resource utilization following video-EEG-confirmed diagnosis of nonepileptic psychogenic seizures

Seizure. 1998 Oct;7(5):385-90. doi: 10.1016/s1059-1311(05)80007-x.


The economic burden of epilepsy is well recognized. However, empirical investigation establishing costs associated with the diagnosis and treatment of non-epileptic psychogenic seizures (NEPS) is lacking. We studied 20 patients with video/EEG monitoring-confirmed NEPS to determine the effect of definitive diagnosis and treatment on medical costs and utilization. A medical resource utilization questionnaire and inpatient medical chart review were employed to calculate utilization information. Medication usage, outpatient visits, emergency room admissions, and diagnostic testing over a 6-month pre-diagnosis and a 6-month post-diagnosis period were compared. There was an 84% average reduction in total seizure-related medical charges in the 6 months following NEPS diagnosis. Average diagnostic testing charges declined 76%, average medication charges decreased 69%, outpatient clinic visits declined 80%, and emergency room visits reduced by 97%. A majority of patients obtaining a definitive inpatient video/EEG-seizure-monitoring-confirmed NEPS diagnosis experience substantial reductions in health care utilization and dollar costs.

MeSH terms

  • Adult
  • Alabama
  • Analysis of Variance
  • Chi-Square Distribution
  • Diagnosis, Differential
  • Diagnostic Techniques, Neurological / economics
  • Electroencephalography* / economics
  • Epilepsy / diagnosis
  • Female
  • Health Care Surveys
  • Health Resources / economics
  • Health Resources / statistics & numerical data*
  • Hospital Costs
  • Hospitals, University / economics
  • Hospitals, University / statistics & numerical data*
  • Humans
  • Length of Stay / economics
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Psychophysiologic Disorders / diagnosis*
  • Psychophysiologic Disorders / economics*
  • Seizures / diagnosis*
  • Seizures / economics*
  • Seizures / psychology
  • Somatoform Disorders / diagnosis*
  • Utilization Review / statistics & numerical data
  • Video Recording / economics