Auras in psychogenic nonepileptic seizures

Area of Science:

• Neurology
• Epilepsy Research
• Psychiatric Disorders

Background:

• Psychogenic nonepileptic seizures (PNES) are often misdiagnosed as epilepsy.
• Auras, commonly associated with focal epilepsy, can also occur in PNES.
• Understanding aura characteristics in PNES is crucial for accurate diagnosis.

Purpose of the Study:

• To determine the frequency and characteristics of auras in patients with PNES.
• To identify historical and clinical risk factors associated with auras in PNES.
• To improve diagnostic accuracy and prevent misdiagnosis in PNES patients.

Main Methods:

• Retrospective database study of 258 PNES patients from 2008-2018.
• Analysis of patient demographics, medical history, and seizure characteristics.
• Logistic regression analysis to identify predictors of aura occurrence.

Main Results:

• 173 (67.1%) PNES patients reported experiencing auras.
• Univariate analysis showed associations between auras and sex, head injury, ictal injury, and antiepileptic drug use.
• Logistic regression identified female sex (OR: 0.498) and head injury history (OR: 0.096) as significant predictors of auras in PNES.

Conclusions:

• Auras are frequent in PNES and can mimic those in focal epilepsy.
• PNES patients with auras are at high risk for misdiagnosis and inappropriate treatment.
• Clinicians must differentiate PNES from epilepsy before prescribing antiepileptic drugs.