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Diagnostic delay in psychogenic nonepileptic seizures
M Reuber1, G Fernández, J Bauer
1Department of Epileptology, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. mreuber@doctors.org.uk
Neurology
|February 13, 2002
Summary
Patients with psychogenic nonepileptic seizures (PNES) face significant diagnostic delays, averaging over seven years. Factors like younger age and specific medical findings prolonged this delay, indicating potential physician-related contributions.
Area of Science:
- Neurology
- Neuroscience
- Psychiatry
Background:
- Psychogenic nonepileptic seizures (PNES) are often misdiagnosed, leading to delayed appropriate treatment.
- Understanding factors contributing to diagnostic delays is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the duration of delay to diagnosis in patients with psychogenic nonepileptic seizures (PNES).
- To identify patient-specific factors associated with prolonged diagnostic delays in PNES.
Main Methods:
- Retrospective analysis of 313 consecutive patients diagnosed with PNES.
- Statistical examination of patient demographics, EEG findings, and treatment history in relation to time to diagnosis.
Main Results:
- The average delay to PNES diagnosis was 7.2 years (SD 9.3 years).
- Younger age, presence of interictal epileptiform discharges on EEG, and prior anticonvulsant treatment were linked to longer diagnostic delays.
- Patient factors alone could not account for the wide variation in diagnostic timelines.
Conclusions:
- Significant delays in diagnosing PNES are common.
- Physician-related factors likely play a substantial role in the prolonged time to diagnosis for PNES, beyond patient-specific variables.