From the Research
Prevalence of Epileptic Seizures in PNES Patients
- The exact percentage of patients with Psychogenic Non-Epileptic Seizures (PNES) who experience actual epileptic seizures is not directly stated in the provided studies 1, 2, 3, 4, 5.
- However, it is mentioned that some patients with PNES may also have epilepsy, and the diagnosis of PNES is often limited to a 'negative' process, characterized as a 'non-disease' (i.e., 'not epilepsy') 1.
- A study found that among patients presenting to an emergency department with presumed seizures, 26.5% actually presented with PNES, while 55.6% presented with epileptic seizures 2.
- Another study estimated that the incidence of PNES was 1.4-4.9/100,000/year, and the prevalence was between 2 to 33 per 100,000, making it a significant neuropsychiatric condition 4.
- It is also noted that many patients with PNES have a tendency to seek medical attention, and PNES make up a larger share of the workload of neurologists and emergency and general physicians 5.
Diagnostic Challenges
- The diagnosis of PNES relies on a multidisciplinary evaluation and is usually based on different combinations of data, including video-EEG monitoring 4.
- However, not all patients present with seizures while under video-EEG monitoring, and not all epileptic seizures produce visible changes in the scalp EEG 4.
- The differential diagnosis between epileptic and non-epileptic seizures can be difficult, and caution is needed in the clinical interpretation of ictal features suggested to be pathognomonic for PNES 1.
- A study proposed a technique utilizing short-term EEG data for the classification of inter-PNES, PNES, and ES segments using time-frequency methods, which showed promising results 3.