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The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery 1/2021

Open Access 01-12-2021 | Epileptic Seizure | Review

Clinical differentiation of psychogenic non-epileptic seizure: a practical diagnostic approach

Authors: I. Putu Eka Widyadharma, Andreas Soejitno, D. P. G. Purwa Samatra, Anna M. G. Sinardja

Published in: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery | Issue 1/2021

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Abstract

Background

Psychogenic non-epileptic seizure (PNES) has long been the counterpart of epileptic seizure (ES). Despite ample of evidence differentiating the two, PNES mistakenly diagnosed as ES was still common, resulting in unnecessary exposure to long-term antiepileptic medications and reduced patient’s and caregiver’s quality of life, not to mention the burgeoning financial costs.

Objectives

In this review, we aimed to elucidate various differences between PNES and epileptic seizure with respect to baseline characteristics, seizure semiology, EEG pattern, and other key hallmark features.

Methods

An unstructured search was carried out in PubMed, MEDLINE, and EMBASE using keywords pertinent to PNES and ES differentiation. Relevant information was subsequently summarized herein.

Results

PNES differs significantly with ES in terms of baseline characteristics, prodromal symptoms, seizure semiology, presence of pseudosleep, and other hallmark features (for instance provoking seizure with suggestion). The combined approach, if applied appropriately, can yield high diagnostic yield.

Conclusions

PNES can be clearly differentiated from ES via careful adherence to a set of valid clinical cues. The summarized clinical hallmarks is highly useful to prevent unnecessary ES diagnosis and treatment with AEDs.
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Metadata
Title
Clinical differentiation of psychogenic non-epileptic seizure: a practical diagnostic approach
Authors
I. Putu Eka Widyadharma
Andreas Soejitno
D. P. G. Purwa Samatra
Anna M. G. Sinardja
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
DOI
https://doi.org/10.1186/s41983-021-00272-w

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