Patients with psychogenic non-epileptic seizures referred to a tertiary epilepsy centre: Patient characteristics in relation to diagnostic delay

N. M. G. Bodde*, R. H. C. Lazeron, J. M. A. Wirken, S. J. van der Kruijs, A. P. Aldenkamp, P. A. J. M. Boon

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: This clinical study examines patient and seizure characteristics of patients with psychogenic non-epileptic seizures (PNES) in a tertiary epilepsy centre. The main focus was whether a new subgroup of PNES patients emerged with a relatively short referral time and possible specific characteristics. Methods: All PNES patients referred to a specialist program in our centre between mid 2007 and mid 2009 were consecutively included. This yielded a study cohort of 90 patients. Results: The majority of the patients have a patient history with many medical symptoms and they were or had been in treatment by a medical specialist. Furthermore diffuse psychological/psychiatric symptoms and subsequent treatments are also remarkably common, in general without a clear psychological diagnosis. The average time between seizure onset and referral to an epilepsy centre is remarkably low (4.29 years). About 50% of the patients were referred within 2 years of seizure onset. This 'active high speed referral group' had significantly more previous psychological complaints, significantly more previous psychological/psychiatric treatments and a trend towards more previous medical investigations. Conclusion: There seems to be a new subgroup of PNES patients with a short referral time, characterized by a more active attitude towards examination of the symptoms in combination with an active attitude to apply for treatment. However, the PNES cohort as a whole is characterized by having somatoform symptoms based on a process of somatization.
Original languageEnglish
Pages (from-to)217-222
JournalClinical Neurology and Neurosurgery
Volume114
Issue number3
DOIs
Publication statusPublished - Apr 2012

Keywords

  • Non-epileptic attack disorder
  • Patient characteristics
  • Delayed diagnosis
  • Referral patterns
  • Psychiatric comorbidity
  • Somatoform disorders
  • Patient history

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