Psychogenic status epilepticus in children

Area of Science:

• Pediatric Neurology
• Child Psychiatry
• Epileptology

Background:

• Psychogenic status epilepticus (PSE) involves prolonged seizures mimicking epilepsy but without epileptogenic activity.
• Children with epilepsy may experience PSE, often alongside other neurological deficits and psychiatric comorbidities.

Purpose of the Study:

• To describe epilepsy features, psychiatric profiles, psychosocial factors, and outcomes in children with PSE.
• To highlight the importance of prompt diagnosis and psychiatric intervention for PSE in pediatric epilepsy patients.

Main Methods:

• Case series of six children (aged 5-15) with confirmed PSE via video/EEG.
• Inclusion of psychiatric assessments, psychosocial evaluations, and long-term outcome monitoring (average 3.6 years).
• Utilized provocation and placebo techniques in two cases.

Main Results:

• All patients had a history of epilepsy and received anticonvulsants prior to PSE suspicion.
• Common comorbidities included depression, anxiety, OCD, and PTSD, often linked to psychosocial stressors.
• Four patients showed improved psychiatric comorbidity and epilepsy control following psychiatric intervention; PSE did not recur in any patient.

Conclusions:

• PSE is a significant consideration in children with epilepsy, with diagnosis often delayed in acute settings.
• Management of comorbid psychiatric disorders is crucial for improving outcomes and reducing PSE recurrence.
• Epilepsy severity and neurological deficits influence overall patient prognosis.