Epilepsy and PNES

Psychogenic Non Epileptic Seizures Information


Is it possible for someone to have both epilepsy and PNES?


• There are a fair number of patients who have PNES and who also have a prior or simultaneous history of epileptic attacks.
  - Researchers have reported anywhere between 10 to 50% of patients with PNES also have some type of epileptic attacks.

• Because of this, it is important to make sure that epileptic attacks are not also occurring in patients with PNES.
  - In order to do this, a detailed history and description of the patient's typical attacks is noted and then carefully compared to those that occur while the patient is undergoing VEEG while in the hospital. These should also be reviewed by family members so that they can confirm or disconfirm if the observed event it similar to the patient's typical events. All typical events should be caught on camera/EEG and determined to be PNES in order for the diagnosis to be given with confidence.

• If there is epilepsy-like activity on EEG and abnormalities in neuroimaging studies (SPECT or PET), the possibility of a dual diagnosis needs to be thoroughly ruled out. A thorough psychiatric history is also very useful in making the diagnosis although it is clearly not sufficient to rule out a co-existing neurological condition.

 

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