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. 2025 Sep;46(9):4615-4621.
doi: 10.1007/s10072-025-08255-y. Epub 2025 May 31.

Case series of functional non epileptic seizures (PNES) in patients with brain tumors

Roni Loebenstein #  1 , Shany Guly Gofrit #  2 , Mailam Eltity  1 , Erez Magiel  1 , Uriel Fennig  1 , Keren Altman  1 , Ory Haisraely  3 , Noga Atar  3 , Elisheva Jan  3 , Naum Margolin  1 , Marina Boxer  1 , Nicola Maggio  1   4   5 , Alisa Taliansky  1   3
Affiliations

Case series of functional non epileptic seizures (PNES) in patients with brain tumors

Roni Loebenstein et al. Neurol Sci. 2025 Sep.

Abstract

Purpose: Functional (Psychogenic) non epileptic seizures (PNES) are events which mimic epileptic seizures without ictal electrical findings on the EEG recording during the events. Diagnosis of PNES is made by correlating the clinical presentation with the lack of ictal activity as diagnosed by video EEG (VEEG) and is crucial for proper decision-making regarding management. Patients with brain tumors have a high prevalence of epileptic seizures. However, clinician's awareness of PNES in those patients is often insufficient.

Patients and methods: We collected data regarding 6 patients with brain tumors which were followed-up in the neuro-oncology unit in Sheba medical center and were diagnosed with epilepsy, along with PNES according to VEEG.

Results: We describe data regarding 6 patients aged 20-68, four of them females, with different brain tumors and in various stages of the disease. PNES were mostly focal, and a clear trigger was identified in four patients. Improvement in PNES frequency alongside a reduction in anti-seizure medicaions followed diagnosis of PNES in 5 out of the 6 patients.

Conclusions: In our case series, PNES were usually focal, and patients did not have all the risk factors associated with PNES in the general population. PNES frequency was unrelated to oncological status. Diagnosis of PNES with open discussion reduced PNES frequency and dosages of anti-seizure medications in our patients.

Keywords: Brain tumors; Epilepsy; Epilepsy monitoring unit; Glioblastoma; PNES; Seizures.

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Conflict of interest statement

Declarations. Ethical approval: This study involves information regarding human patients. The study was approved by the Chaim Sheba Medical Center Ethics Committee (118-24-SMC). Informed consent was exempt due to the retrospective nature of the study. Competing Interests: The authors have no relevant financial or non-financial interests to disclose.

References

    1. Bodde NMG, Brooks JL, Baker GA et al (2009) Psychogenic non-epileptic seizures—Definition, etiology, treatment and prognostic issues: A critical review. Seizure 18:543–553. 10.1016/j.seizure.2009.06.006 - PubMed
    1. Asadi-Pooya AA, Sperling MR (2015) Epidemiology of psychogenic nonepileptic seizures. Epilepsy Behav 46:60–65. 10.1016/j.yebeh.2015.03.015 - PubMed
    1. LaFrance WC, Benbadis SR (2006) Avoiding the costs of unrecognized psychological nonepileptic seizures. Neurology 66:1620–1621. 10.1212/01.wnl.0000224953.94807.be - PubMed
    1. Razvi S, Mulhern S, Duncan R (2012) Newly diagnosed psychogenic nonepileptic seizures: health care demand prior to and following diagnosis at a first seizure clinic. Epilepsy Behav 23:7–9. 10.1016/j.yebeh.2011.10.009 - PubMed
    1. Akeret K, Serra C, Rafi O et al (2019) Anatomical features of primary brain tumors affect seizure risk and semiology. NeuroImage Clin 22:101688. 10.1016/j.nicl.2019.101688 - PMC - PubMed

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