Psychopathology of Patients with Psychogenic Nonepileptic Spells (PNES) Referred for Video-EEG Monitoring (P01.041)

Abstract

Objective: To determine if psychogenic nonepileptic spells can be differentiated from epileptic seizures based on psychological issues as well as intelligence levels. Background Psychogenic Nonepileptic Spells (PNES) are recurrent paroxysmal events that are often misdiagnosed as epilepsy. Neuropsychological variables may discriminate PNES and epilepsy, helping physicians to suspect PNES earlier. We tested the hypothesis that patients with PNES, when compared to those with epilepsy, differ in personality characteristics and will have elevated levels of psychological distress (as measured by the Millon Clinical Multiaxial Inventory [MCMI]), but will not differ in intelligence (as measured by the Wechsler Adult Intelligence Scale III [WAIS-III]). Design/Methods: Retrospective analysis was performed on 280 patients diagnosed with either PNES or epilepsy in UPMC9s Epilepsy Monitoring Unit from 2009 to 2011. MCMI and WAIS-III scores were analyzed using a Mann-Whitney U test. Results: Patients with PNES (N=158), compared to those with epilepsy (N=122), scored higher on every MCMI variable. Many of these differences reached statistical significance (Avoidant [p=0.011], Passive-Aggressive [p 0.05) between both groups, suggesting similar intelligence levels. Conclusions: PNES patients, when compared to epilepsy patients, have significantly elevated levels of psychological distress as measured by the MCMI, but do not differ in intelligence as assessed by the WAIS-III. These results confirm the utility of the MCMI, but not the WAIS-III, as an instrument in suspecting spells as either PNES or epileptic seizures. Disclosure: Dr. Popescu has nothing to disclose. Dr. Dixit has nothing to disclose. Dr. Bagic has nothing to disclose. Dr. Ghearing has nothing to disclose. Dr. Hendrickson has nothing to disclose.