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Review
. 2014 Oct 15:10:1979-86.
doi: 10.2147/NDT.S49531. eCollection 2014.

Long-term video EEG monitoring for diagnosis of psychogenic nonepileptic seizures

Evan R Gedzelman  1 , Suzette M LaRoche  1
Affiliations
Review

Long-term video EEG monitoring for diagnosis of psychogenic nonepileptic seizures

Evan R Gedzelman et al. Neuropsychiatr Dis Treat. .

Abstract

Psychogenic nonepileptic seizures have long been known by many names. A short list includes hysteroepilepsy, hysterical seizures, pseudoseizures, nonepileptic events, nonepileptic spells, nonepileptic seizures, and psychogenic nonepileptic attacks. These events are typically misdiagnosed for years and are frequently treated as electrographic seizures and epilepsy. These patients experience all the side effects of antiepileptic drugs and none of the benefits. Video electroencephalogram (EEG) monitoring is the gold standard diagnostic test that can make a clear distinction between psychogenic nonepileptic seizures and epilepsy. Video EEG allows us to correctly characterize the patient's events and therefore properly diagnose and direct management. As a result, years of faulty management and wasted health care dollars can be avoided.

Keywords: antiepileptic drugs; cognitive behavioral therapy; conversion disorder; electroencephalogram; psychogenic nonepileptic seizures; video EEG monitoring.

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Figures

Figure 1
Figure 1
The PT transitions into a typical PNES. Notes: Immediately prior to it, the EEG background shows a normal waking rhythm. The EEG is then obscured by movement and muscle artifact that is most prominent in the posterior regions. Abbreviations: PT, patient; PNES, psychogenic nonepileptic seizure; EEG, electroencephalogram.
Figure 2
Figure 2
The patient is in the middle of a typical PNES. Notes: The EEG background is obscured by movement and muscle artifact that is most prominent in the posterior regions. There is an embedded 1-second period when the movement stops and normal background is seen before the background is again obscured by movement and muscle artifact. Abbreviations: PNES, psychogenic nonepileptic seizure; EEG, electroencephalogram.
Figure 3
Figure 3
The patient transitions out of a typical PNES. Notes: Initially, the slide shows EEG background obscured by movement and muscle artifact that is most prominent in the posterior regions. Immediately after it, the EEG background returns to a normal waking background. Abbreviations: PNES, psychogenic nonepileptic seizure; EEG, electroencephalogram.
See this image and copyright information in PMC

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