Psychogenic nonepileptic seizures in pediatric population: A review.

Francesca Felicia Operto,Lucia Margari,Giangennaro Coppola,Michele Roccella,Stella Campanozzi,Grazia Maria Giovanna Pastorino,Marco Carotenuto,Roberta Mazza,Rosa Marotta

doi:10.1002/brb3.1406

Abstract

IntroductionPsychogenic nonepileptic seizures (PNES) are observable abrupt paroxysmal changes in behavior or consciousness that resemble epileptic seizures, but without concurrent electroencephalographic abnormalities.MethodsIn this manuscript, we reviewed literature concerning pediatric PNES and focused on those articles published in the last 10 years, in order to try to understand what the state of the art is at the moment, particularly as regards relationship and differential diagnosis with epilepsy.ResultsPsychogenic nonepileptic seizures have been extensively described in literature mainly in adults and less frequently in children. Despite the potential negative impact of a misdiagnosis (unnecessary investigations and antiepileptic drugs, structured pathological behavioral patterns), in literature there is little information regarding the real prevalence, clinical features, treatment, and outcome of PNES in children and adolescents.ConclusionPsychogenic nonepileptic seizures are common but frequently missed entity in pediatric population. Diagnosis could be difficult, especially in those children who have both epileptic and nonepileptic seizures; video EEG and home video can help clinicians in diagnosis. More studies are needed to better classify PNES in children and facilitate diagnosis and treatment.

Highlights

Psychogenic nonepileptic seizures (PNES) are observable abrupt paroxysmal changes in behavior or consciousness that resemble epileptic seizures, but without concurrent electroencephalographic abnormalities
Several terminologies have been used in literature to describe these paroxysmal events, including pseudoseizures, psychogenic seizures, hysterical epilepsy, pseudoepileptic seizures, and nonphysiologic or functional seizures; the term “psychogenic nonepileptic seizures” is preferable as it clearly indicates the nonepileptic nature of these clinical conditions, which are thought to have a psychogenic basis
We especially focused on those article that better described semiology and clinical features of PNES in pediatric population, in order to try to understand what the state of the art is at the moment, as regards relationship and differential diagnosis with epilepsy

Summary

Introduction

Psychogenic nonepileptic seizures (PNES) are observable abrupt paroxysmal changes in behavior or consciousness that resemble epileptic seizures, but without concurrent electroencephalographic abnormalities. Results: Psychogenic nonepileptic seizures have been extensively described in literature mainly in adults and less frequently in children. Psychogenic nonepileptic seizures (PNES) are observable abrupt paroxysmal changes in behavior or consciousness that resemble epileptic seizures but without concurrent electroencephalographic abnormalities (Madaan et al, 2018). Psychogenic nonepileptic seizures have been described extensively in literature mainly in adults and less frequently in children (Patel, Scott, Dunn, & Garg, 2007). There are few population‐based data on pediatric PNES (Madaan et al, 2018); so, it is difficult to accurately estimate their exact incidence or prevalence in children and adolescents (Reilly, Menlove, Fenton, & Das, 2013). According to Dhiman et al and earlier studies, the prevalence of PNES is 3.5%–20% of children and adolescents undergoing video EEG (vEEG) monitoring (Dhiman, Sinha, & Rawat, 2014; Kutluay, Selwa, Minecan, Edwards, & Beydoun, 2010; Szabó, Siegler, & Zubek, 2012)

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