Abstract
We thank Marcia Kaplan for her valuable comments, which enrich the complicated neuropsychiatric picture of patients affected by psychogenic nonepileptic seizures (PNES). Psychogenic seizures are the most common nonepileptic events that may be misdiagnosed [ [1] Benbadis S.R. Allen Hauser W.A. An estimate of the prevalence of psychogenic non-epileptic seizures. Seizure. 2000; 9: 280-281 Abstract Full Text PDF PubMed Scopus (399) Google Scholar ] thus producing an estimated lifetime dollar cost of $100,000 per patient [ [2] Martin R.C. Gilliam F.G. Kilgore M. Faught E. Kuzniecky R. Improved health care resource utilization following video-EEGconfirmed diagnosis of nonepileptic psychogenic seizures. Seizure. 1998; 7: 385-390 Abstract Full Text PDF PubMed Scopus (218) Google Scholar ]. Generally, early diagnosis and recognition of critical symptoms are complicated. Most patients fulfill the diagnostic criteria of conversion (Diagnostic and Statistical Manual for Psychiatric Disorders — 5th edition (DSM-5)) or dissociative disorders (International Classification of Diseases — 10th revision (ICD-10)), although the most prominent psychiatric symptoms rely on depression or anxiety disorders [ [3] Widdess-Walsh P. Mostacci B. Tinuper P. Devinsky O. Psychogenic nonepileptic seizures. Handb Clin Neurol. 2012; 107: 277-295 Crossref PubMed Scopus (10) Google Scholar ]. Among these heterogenic features, it is important to bear in mind that internationally accepted diagnostic criteria for PNES do not exist yet. For this reason, clinicians are firstly interested in distinguishing the neuropsychiatric profile of PNES from other similar clinical realms such as temporal lobe epilepsy, psychogenic movement disorder, or major depression.
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