Loss of responsiveness in psychogenic non-epileptic seizures

Abstract

The aim of this study was to investigate the frequency of loss of responsiveness (LOR) in patients with psychogenic non-epileptic seizures (PNES) and to characterize the patients' clinical variables that may be associated with such a manifestation. In this retrospective study, all patients with documented PNES, who were investigated at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 to 2018, were investigated. During the study period, data was available for 324/325 patients with PNES. In total, 275 patients (85%) reported LOR during their seizures, but this was not the case for 49 patients (15%). The model, generated by regression analysis, was shown to be significant (p=0.0001) and LOR could be predicted in 84% of the patients. Closed eyes during seizures (OR: 4.4; 95% CI: 2.101-9.235; p=0.0001) and seizure-associated injury (OR: 3.5; 95% CI: 1.402-8.686; p=0.007) were significantly associated with LOR based on the model. Patients with PNES may frequently report LOR, which is significantly associated with seizure-related injuries. Therefore, it is important to apply appropriate management strategies for patients with PNES and LOR in order to prevent or decrease the possibility of any associated consequences, including ictal injury.

Keywords: PNES; psychogenic; responsiveness; seizure; semiology.