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Clinical spectrum of psychogenic non epileptic seizures in children; an observational study

Priyanka Madaan1, Sheffali Gulati1, Biswaroop Chakrabarty1

  • 1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.

Seizure
|May 14, 2018
PubMed

Insights

Dialeptic Psychogenic Non-Epileptic Seizures (PNES) are most common in children. Short-term video electroencephalogram (STVEEG) with induction offers reliable diagnosis for pediatric PNES, especially in resource-limited areas.

Area of Science:

  • Pediatric Neurology
  • Child Psychiatry
  • Clinical Neurophysiology

Background:

  • Psychogenic Non-Epileptic Seizures (PNES) present a diagnostic challenge in children.
  • Understanding the clinical spectrum is crucial for effective management.
  • Previous studies have highlighted varied presentations and diagnostic delays.

Purpose of the Study:

  • To analyze the clinical spectrum of Psychogenic Non-Epileptic Seizures (PNES) in pediatric patients.
  • To evaluate diagnostic methods and identify common comorbidities and stressors.
  • To inform comprehensive management strategies for pediatric PNES.

Main Methods:

  • Study included 80 children aged 6-16 years with suspected PNES.
  • Diagnosis confirmed using short-term video electroencephalogram (STVEEG) and induction.
  • Assessments included stressors, comorbidities, IQ, and behavioral abnormalities via standardized tests and criteria.

Main Results:

  • Dialeptic semiology was the most frequent type of PNES (42.5%).
  • A median diagnostic delay of 5 months was observed, with 45% of patients already on antiepileptic drugs.
  • Family stressors were prevalent, and adjustment disorder was the most common psychiatric comorbidity.

Conclusions:

  • Dialeptic PNES is the predominant subtype in children.
  • STVEEG with induction is a reliable diagnostic tool for pediatric PNES, particularly in resource-constrained settings.
  • A holistic management approach requires comprehensive assessment, including evaluation of stressors.
Abstract

Keywords:
Dialeptic PNESHouse tree person testPsychogenic nonepileptic seizuresShort term video EEG

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