From the Research
There is currently no established relationship between elevated C-reactive protein (CRP) levels and psychogenic non-epileptic seizures (PNES). While CRP is an inflammatory marker that increases in response to infection, inflammation, and tissue damage, PNES are episodes that resemble epileptic seizures but have psychological rather than neurological causes. PNES are typically associated with psychological factors such as trauma, stress, or emotional distress rather than the inflammatory processes that would elevate CRP. Some patients with PNES may coincidentally have elevated CRP due to unrelated conditions, but CRP testing is not used for PNES diagnosis or management.
Key Points
- The diagnosis of PNES relies primarily on video-EEG monitoring showing normal brain activity during typical events, along with psychological assessment 1.
- Treatment for PNES focuses on psychological interventions such as cognitive behavioral therapy, trauma-focused therapy, and stress management techniques, rather than anti-inflammatory approaches that might be considered if CRP elevation were causally related.
- A study on anxiety and stress-related disorders found an association between these disorders and high levels of inflammatory markers, as measured by CRP, but this does not directly relate to PNES 2.
- Another study found that epileptic patients had significantly increased CRP levels in peripheral blood compared with healthy controls, indicating a significant association between inflammation and epilepsy, but this is not directly applicable to PNES 3.
Considerations
- The lack of direct evidence linking CRP levels to PNES suggests that CRP testing is not a useful tool in the diagnosis or management of PNES.
- The focus of treatment for PNES should remain on addressing the underlying psychological factors, rather than pursuing anti-inflammatory treatments based on CRP levels.
- Further research may be needed to fully understand the relationship between inflammatory markers and PNES, but current evidence does not support a causal link between CRP elevation and PNES.