Seizures, Nonepileptic Events, Trauma, Anxiety, or All of the Above

Abstract

Psychiatric Comorbidity and Traumatic Brain Injury Attribution in Patients With Psychogenic Nonepileptic or Epileptic Seizures: A Multicenter Study of US Veterans Salinsky M, Rutecki P, Parko K, Goy E, Storzbach D, O’Neil M, Binder L, Joos S. Epilepsia. 2018. Epub ahead of print. https://doi.org/10.1111/epi.14542 Objective: To determine the frequency and severity of psychiatric disorders and attribution of seizures to traumatic brain injury (TBI) in veterans with verified psychogenic nonepileptic seizures (PNES) versus epileptic seizures (ES). Methods: We studied 333 consecutive admissions to the monitoring units of 3 Veterans Administration epilepsy centers. All patients underwent continuous video-electroencephalographic recording to define definite PNES or ES. Evaluations included the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, posttraumatic stress disorder (PTSD) Checklist, Beck Depression Inventory II, and Patient Seizure Etiology Questionnaire. Interviews and questionnaires were completed prior to final seizure type diagnosis and patient debriefing. The primary outcome measure was a comparison of Axis I psychiatric diagnoses in patients diagnosed with PNES versus ES. Results: A total of 81 patients were diagnosed with PNES and 70 with ES. Posttraumatic stress disorder was the most frequent Axis I diagnosis in veterans with PNES (64% vs 13% of those with ES; P