Psychogenic non-epileptic seizures in individuals with intellectual disability/borderline cognitive function:...

Area of Science:

• Neurology
• Neuropsychology
• Epileptology

Background:

• Psychogenic non-epileptic seizures (PNES) are functional neurological disorder events.
• Understanding PNES in individuals with intellectual disability (ID) or borderline intellectual function (BIF) is crucial for tailored clinical management.
• Previous research has not fully elucidated the clinical characteristics and treatment responses in this specific population.

Purpose of the Study:

• To characterize PNES in individuals with ID/BIF compared to those with normal cognitive function.
• To identify differences that could inform improved clinical management protocols for PNES.
• To assess the efficacy of current treatment strategies across cognitive function groups.

Main Methods:

• Retrospective, observational, single-center study of PNES patients (≥14 years) diagnosed via video-electroencephalography (vEEG).
• Inclusion of patients with comprehensive neuropsychological evaluations.
• Comparison of two groups: normal cognition (IQ≥85) and mild ID/BIF (n=25 each), analyzing demographic, clinical, and vEEG data.

Main Results:

• No statistically significant clinical differences were found between the ID/BIF and normal cognition groups.
• Diagnostic delay and prescription of inappropriate antiseizure medications (ASMs) were comparable between groups.
• Behavioral psychotherapeutic approaches, including cognitive behavioral therapy (CBT), showed similar positive outcomes in both subgroups.

Conclusions:

• Clinical management of PNES in individuals with mild ID/BIF is similar to those with normal cognitive function.
• Demographic, clinical, and seizure semiology data are comparable across cognitive levels.
• Cognitive behavioral therapy (CBT) is an effective treatment for PNES, regardless of mild ID/BIF status; further research is needed for moderate/severe ID.