To study the Clinical Psychological and Neurological Profile and Assessing the Outcome Predictors of Patients with Psychogenic Non Epileptic Seizures (PNES): A Study of 74 Cases

Objective To Study the Clinical, Psychological and Neurological Profile and Assessing the Outcome Predictors of Patients with Psychogenic Non Epileptic Seizures in North Indian adult population. Design of studyA prospective observational study, conducted at tertiary teaching institute at Jaipur. Materials and MethodsSeventy-four patients with PNES were enrolled. The diagnosis was based on mobile recordings of episodes, and video-electroencephalography (video-EEG) monitoring. A detailed clinical evaluation was done including evaluation for coexistent anxiety, depression or other psychiatric disorder. Patients were followed-up to 2 months. Statistical AnalysisAppropriate statistical tests were used. ResultsThe mean age at onset was 22 years, with female to male ratio were 17.51. Coexisting epilepsy was present in 6 (8.10 %).40 patients (54.05 %) had received one or multiple antiepileptic drugs. Out of 74 patients of PNES 48 (64.86 %) had predominant motor phenomenon, whereas 26 patients (35.13 %) had other manifestations. The common features observed were jaw clinching, ictal eye closure, pre-ictal headache, ictal weeping, resistant behavior, ictal vocalization, and unresponsiveness during episodes. Comorbid anxiety and depressive disorders was seen in 43 (58.10 %) and 62 (83.78 %) patients respectively. Short-term (2 months) outcome of 62 patients was good (seizure freedom in 49{66.21 %} and greater than50 % improvement in 21{28.37 %}). ConclusionPNES is common, but frequently misdiagnosed and treated as epileptic seizures. A high index of suspicion is required for an early diagnosis. Proper disclosure of diagnosis and management of the psychiatric comorbidities can improve their outcome. LimitationLimited sample size, change in seizures frequency, socio-occupational functioning, quality of life was not assessed