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Evaluating Patients With Suspected Nonepileptic Psychogenic Seizures

Received April 4, 2008; revised August 18, 2008; accepted September 8, 2008. The authors are affiliated with Projeto de Epilepsia e Psiquiatria (PROJEPSI), Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, and with Laboratório de Neurofisiologia, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Address correspondence to Dr. Renato Luiz Marchetti, Rua Cayowaa 1236 ap.61, São Paulo SP Brazil CEP 05018-001; rlmarche{at}bighost.com.br (e-mail).

The authors evaluate 26 patients with suspected psychogenic non-epileptic seizures (PNES) who were referred to prolonged intensive video EEG (VEEG) in an epilepsy diagnostic center at the University of São Paulo, Brazil. Following the investigative protocol, 50% of the patients received a diagnosis of PNES, 15.4% of epilepsy, and 34.6% of associated PNES and epilepsy. In all patients in our series, PNES were the pseudoneurological presentations of dissociative or conversion symptoms in patients presenting the following mental disorders: conversion disorder, somatization or undifferentiated somatoform disorder, dissociative disorder not otherwise specified, and posttraumatic stress disorder. Psychiatric comorbidities, mostly depressive disorders, were frequent.

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