Structural brain abnormalities in patients with psychogenic nonepileptic seizures

Area of Science:

• Neurology
• Neuroimaging
• Epilepsy

Background:

• Psychogenic nonepileptic seizures (PNES) are functional neurological disorder characterized by episodes resembling epileptic seizures but without abnormal electrical discharges in the brain.
• The prevalence of structural brain abnormalities in patients with PNES is debated, with some studies suggesting a significant proportion may have underlying brain pathology.

Purpose of the Study:

• To investigate the association between clinical features of patients with psychogenic nonepileptic seizures (PNES) and brain imaging results.
• To determine if specific clinical factors correlate with structural brain abnormalities in PNES patients.

Main Methods:

• A retrospective study was conducted at Shiraz Comprehensive Epilepsy Center, Iran, from 2008 to 2019.
• One hundred thirty-two patients with PNES had available brain magnetic resonance imaging (MRI) data analyzed.

Main Results:

• Thirty-six percent of patients (47/132) exhibited abnormal findings on their brain MRI.
• Advanced age (OR=1.040) and comorbid epilepsy (OR=3.006) were significantly associated with abnormal brain MRI results.
• Structural brain abnormalities were more prevalent in patients with both PNES and epilepsy (41%) compared to those with PNES only (5%).

Conclusions:

• While structural brain abnormalities appear relatively common in PNES, current data is limited.
• Further well-designed, multicenter studies with standardized imaging methodologies are needed to clarify the significance of these abnormalities in PNES development.