Reading materials on PNES


(Abst. 1.266), 2017
American Epilepsy Society
Are there cognitive differences between men and women with psychogenic non-epileptic seizures.

Rationale: To determine whether male and female populations of patients with psychogenic non-epileptic seizures (PNES) differ with regards to cognitive function.

Methods: Background: Research on cognition in PNES has generally revealed deficits in attention and executive functions. Specific memory deficits in patients dually diagnosed with PNES and post-traumatic stress (PTS) have also been reported. However, because PNES is over-represented by females; specific information about cognition in males PNES is limited. This is a retrospective study of 47 consecutive males (2007 to 2016) and 87 consecutive females (2014 to 2016) with video EEG-confirmed diagnosis of PNES. Subjects were excluded if they had "failed" the Test of Memory Malingering (TOMM) or if they had an IQ of less than 70. Patients were examined on subtests of the Delis Kaplan Executive Function System (DKEFS), Boston Naming Test (BNT), California Verbal Learning Test-2 (CVLT-2), Continuous Visual Memory Test (CVMT), Grooved Pegboard Test (GPT), and Rey-Osterrieth Figure Copy (ROCFT).

Results: Mean age of the sample is 35.66 years (SD ±13.16) and mean years of education is 13.38 (SD ±2.35). As a whole, the following percentages of subjects performed in the very deficient range (defined as >2 standard deviations below the norm): 59% on the BNT, 66% on CVLT-2 intrusions, 41% on CVLT-2 false positives, 50% on CVMT Total score and 45% on false positives, 38% on the ROCFT copy, and 59% on the GPT with dominant hand and 54% with the non-dominant hand. However, there were no significant differences identified between genders regarding demographic variables or on any of the cognitive measures administered.

Conclusions: There were no significant differences identified between men and women on any of cognitive measures. However, as a whole, a substantial number of subjects demonstrated deficits suggesting weaknesses of inhibitory processes, fine motor skills, and word finding. This is consistent with reports of cognitive differences in those with PNES regarding higher level attention and executive functions.