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Weeping during psychogenic nonepileptic seizures
1Department of Neurology, College of Physicians & Surgeons, Columbia University, New York, New York, USA.
Epilepsia
|February 1, 1996
Summary
Ictal weeping, or crying during seizures, was not observed in epileptic seizures but occurred in 31% of patients with psychogenic nonepileptic seizures (PNES). This finding helps differentiate PNES from epilepsy.
Area of Science:
- Neurology
- Clinical Neurophysiology
Background:
- Distinguishing epileptic seizures from psychogenic nonepileptic seizures (PNES) is crucial for accurate diagnosis and treatment.
- Ictal weeping has been anecdotally suggested as a potential differentiator, but its prevalence is not well-established.
Purpose of the Study:
- To determine the prevalence of ictal weeping in patients with PNES and epileptic seizures.
- To evaluate the utility of ictal weeping as a clinical marker for differentiating between these two conditions.
Main Methods:
- Retrospective review of video recordings of seizures from 84 consecutive patients diagnosed with either PNES or epilepsy.
- Systematic observation and documentation of weeping occurring during or immediately after ictal events.
Main Results:
- Ictal weeping was observed in 14% of PNES events and in 31% of patients with PNES.
- No instances of ictal weeping were recorded during epileptic seizures in 48 patients.
- The presence of ictal weeping was highly statistically significant in PNES compared to epileptic seizures.
Conclusions:
- Ictal weeping is a significant clinical feature that can help differentiate psychogenic nonepileptic seizures from epileptic seizures.
- The absence of weeping during an event strongly suggests it is an epileptic seizure, while its presence supports a diagnosis of PNES.