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Non-epileptic seizure

MedGen UID:
853160
•Concept ID:
C1142430
•
Mental or Behavioral Dysfunction
Synonyms: Functional seizure; Psychogenic non-epileptic seizure; Psychogenic Seizure; Psychogenic seizures; Psychosomatic seizure
SNOMED CT: Psychogenic seizures (191714002)
 
HPO: HP:0033052

Definition

Psychogenic non-epileptic seizures (PNES) are not abnormal perceptions or abnormal beliefs/judgments, nor are they epileptic attacks. They are behaviors that simulate epileptic attacks, not fully consciously. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVNon-epileptic seizure

Conditions with this feature

SIN3A-related intellectual disability syndrome due to a point mutation
MedGen UID:
934771
•Concept ID:
C4310804
•
Disease or Syndrome
Witteveen-Kolk syndrome (WITKOS) is an autosomal dominant disorder with characteristic distinctive facial features, microcephaly, short stature, and mildly impaired intellectual development with delayed cognitive and motor development and subtle anomalies on MRI-brain imaging (summary by Balasubramanian et al., 2021).
See: Condition Record
SIN3A-related intellectual disability syndrome due to a point mutation

Professional guidelines

PubMed

Utility of serum lactate on differential diagnosis of seizure-like activity: A systematic review and meta-analysis.
Patel J, Tran QK, Martinez S, Wright H, Pourmand A
Seizure 2022 Nov;102:134-142. Epub 2022 Oct 7 doi: 10.1016/j.seizure.2022.10.007. PMID: 36242832
The clinical utility of non-invasive video-electroencephalographic monitoring has been diversifying.
Cho YW, Motamedi GK, Kim KT
Neurol Sci 2019 Dec;40(12):2625-2631. Epub 2019 Aug 8 doi: 10.1007/s10072-019-04022-y. PMID: 31392643
Management of psychogenic non-epileptic seizures: a multidisciplinary approach.
Gasparini S, Beghi E, Ferlazzo E, Beghi M, Belcastro V, Biermann KP, Bottini G, Capovilla G, Cervellione RA, Cianci V, Coppola G, Cornaggia CM, De Fazio P, De Masi S, De Sarro G, Elia M, Erba G, Fusco L, Gambardella A, Gentile V, Giallonardo AT, Guerrini R, Ingravallo F, Iudice A, Labate A, Lucenteforte E, Magaudda A, Mumoli L, Papagno C, Pesce GB, Pucci E, Ricci P, Romeo A, Quintas R, Sueri C, Vitaliti G, Zoia R, Aguglia U
Eur J Neurol 2019 Feb;26(2):205-e15. Epub 2018 Nov 29 doi: 10.1111/ene.13818. PMID: 30300463

Recent clinical studies

Etiology

Executive functioning and social skills in children with epileptic seizures and non-epileptic seizures.
Levan A, Fegter O, Gale SD
Epilepsy Res 2022 Dec;188:107051. Epub 2022 Nov 4 doi: 10.1016/j.eplepsyres.2022.107051. PMID: 36379123
Forecasting psychogenic non-epileptic seizure likelihood from ambulatory EEG and ECG.
Xiong W, Kameneva T, Lambert E, Cook MJ, Richardson MP, Nurse ES
J Neural Eng 2022 Nov 3;19(5) doi: 10.1088/1741-2552/ac9c97. PMID: 36270501
Reliability of reported peri-ictal behavior to identify psychogenic nonepileptic seizures.
Kerr WT, Chau AM, Janio EA, Braesch CT, Le JM, Hori JM, Patel AB, Gallardo NL, Bauirjan J, Allas CH, Karimi AH, Hwang ES, Davis EC, Buchard A, Torres-Barba D, D'Ambrosio S, Al Banna M, Cho AY, Engel J Jr, Cohen MS, Stern JM
Seizure 2019 Apr;67:45-51. Epub 2019 Mar 5 doi: 10.1016/j.seizure.2019.02.021. PMID: 30884437Free PMC Article
Management of psychogenic non-epileptic seizures: a multidisciplinary approach.
Gasparini S, Beghi E, Ferlazzo E, Beghi M, Belcastro V, Biermann KP, Bottini G, Capovilla G, Cervellione RA, Cianci V, Coppola G, Cornaggia CM, De Fazio P, De Masi S, De Sarro G, Elia M, Erba G, Fusco L, Gambardella A, Gentile V, Giallonardo AT, Guerrini R, Ingravallo F, Iudice A, Labate A, Lucenteforte E, Magaudda A, Mumoli L, Papagno C, Pesce GB, Pucci E, Ricci P, Romeo A, Quintas R, Sueri C, Vitaliti G, Zoia R, Aguglia U
Eur J Neurol 2019 Feb;26(2):205-e15. Epub 2018 Nov 29 doi: 10.1111/ene.13818. PMID: 30300463
Utility of different seizure induction protocols in psychogenic nonepileptic seizures.
Goyal G, Kalita J, Misra UK
Epilepsy Res 2014 Aug;108(6):1120-7. Epub 2014 Apr 8 doi: 10.1016/j.eplepsyres.2014.02.015. PMID: 24802296

Diagnosis

Association between brain metabolism and clinical course of motor functional neurological disorders.
Conejero I, Collombier L, Lopez-Castroman J, Mura T, Alonso S, Olié E, Boudousq V, Boulet F, Arquizan C, Boulet C, Wacongne A, Heitz C, Castelli C, Mouchabac S, Courtet P, Abbar M, Thouvenot E
Brain 2022 Sep 14;145(9):3264-3273. doi: 10.1093/brain/awac146. PMID: 35445242
Artificial intelligence as an emerging technology in the current care of neurological disorders.
Patel UK, Anwar A, Saleem S, Malik P, Rasul B, Patel K, Yao R, Seshadri A, Yousufuddin M, Arumaithurai K
J Neurol 2021 May;268(5):1623-1642. Epub 2019 Aug 26 doi: 10.1007/s00415-019-09518-3. PMID: 31451912
Reliability of reported peri-ictal behavior to identify psychogenic nonepileptic seizures.
Kerr WT, Chau AM, Janio EA, Braesch CT, Le JM, Hori JM, Patel AB, Gallardo NL, Bauirjan J, Allas CH, Karimi AH, Hwang ES, Davis EC, Buchard A, Torres-Barba D, D'Ambrosio S, Al Banna M, Cho AY, Engel J Jr, Cohen MS, Stern JM
Seizure 2019 Apr;67:45-51. Epub 2019 Mar 5 doi: 10.1016/j.seizure.2019.02.021. PMID: 30884437Free PMC Article
Management of psychogenic non-epileptic seizures: a multidisciplinary approach.
Gasparini S, Beghi E, Ferlazzo E, Beghi M, Belcastro V, Biermann KP, Bottini G, Capovilla G, Cervellione RA, Cianci V, Coppola G, Cornaggia CM, De Fazio P, De Masi S, De Sarro G, Elia M, Erba G, Fusco L, Gambardella A, Gentile V, Giallonardo AT, Guerrini R, Ingravallo F, Iudice A, Labate A, Lucenteforte E, Magaudda A, Mumoli L, Papagno C, Pesce GB, Pucci E, Ricci P, Romeo A, Quintas R, Sueri C, Vitaliti G, Zoia R, Aguglia U
Eur J Neurol 2019 Feb;26(2):205-e15. Epub 2018 Nov 29 doi: 10.1111/ene.13818. PMID: 30300463
The pediatric non-epileptic seizure.
Tamer SK
Indian J Pediatr 1997 Sep-Oct;64(5):671-6. doi: 10.1007/BF02726123. PMID: 10771901

Therapy

Utility of serum lactate on differential diagnosis of seizure-like activity: A systematic review and meta-analysis.
Patel J, Tran QK, Martinez S, Wright H, Pourmand A
Seizure 2022 Nov;102:134-142. Epub 2022 Oct 7 doi: 10.1016/j.seizure.2022.10.007. PMID: 36242832
Machine learning applications to differentiate comorbid functional seizures and epilepsy from pure functional seizures.
Asadi-Pooya AA, Kashkooli M, Asadi-Pooya A, Malekpour M, Jafari A
J Psychosom Res 2022 Feb;153:110703. Epub 2021 Dec 15 doi: 10.1016/j.jpsychores.2021.110703. PMID: 34929547
Utility of different seizure induction protocols in psychogenic nonepileptic seizures.
Goyal G, Kalita J, Misra UK
Epilepsy Res 2014 Aug;108(6):1120-7. Epub 2014 Apr 8 doi: 10.1016/j.eplepsyres.2014.02.015. PMID: 24802296
Psychological and behavioural treatments for adults with non-epileptic attack disorder.
Martlew J, Pulman J, Marson AG
Cochrane Database Syst Rev 2014 Feb 11;2014(2):CD006370. doi: 10.1002/14651858.CD006370.pub2. PMID: 24519702Free PMC Article
The pediatric non-epileptic seizure.
Tamer SK
Indian J Pediatr 1997 Sep-Oct;64(5):671-6. doi: 10.1007/BF02726123. PMID: 10771901

Prognosis

Longitudinal Comparison of PNES spell and ASM reduction in PNES Patients with and without Epilepsy Discharged from an Epilepsy Monitoring Unit.
Yaraki PT, Yu YJ, AlKhateeb M, Mirsattari SM
Epilepsy Res 2024 Mar;201:107319. Epub 2024 Feb 13 doi: 10.1016/j.eplepsyres.2024.107319. PMID: 38422801
Association between brain metabolism and clinical course of motor functional neurological disorders.
Conejero I, Collombier L, Lopez-Castroman J, Mura T, Alonso S, Olié E, Boudousq V, Boulet F, Arquizan C, Boulet C, Wacongne A, Heitz C, Castelli C, Mouchabac S, Courtet P, Abbar M, Thouvenot E
Brain 2022 Sep 14;145(9):3264-3273. doi: 10.1093/brain/awac146. PMID: 35445242
Artificial intelligence as an emerging technology in the current care of neurological disorders.
Patel UK, Anwar A, Saleem S, Malik P, Rasul B, Patel K, Yao R, Seshadri A, Yousufuddin M, Arumaithurai K
J Neurol 2021 May;268(5):1623-1642. Epub 2019 Aug 26 doi: 10.1007/s00415-019-09518-3. PMID: 31451912
Reliability of reported peri-ictal behavior to identify psychogenic nonepileptic seizures.
Kerr WT, Chau AM, Janio EA, Braesch CT, Le JM, Hori JM, Patel AB, Gallardo NL, Bauirjan J, Allas CH, Karimi AH, Hwang ES, Davis EC, Buchard A, Torres-Barba D, D'Ambrosio S, Al Banna M, Cho AY, Engel J Jr, Cohen MS, Stern JM
Seizure 2019 Apr;67:45-51. Epub 2019 Mar 5 doi: 10.1016/j.seizure.2019.02.021. PMID: 30884437Free PMC Article
Utility of different seizure induction protocols in psychogenic nonepileptic seizures.
Goyal G, Kalita J, Misra UK
Epilepsy Res 2014 Aug;108(6):1120-7. Epub 2014 Apr 8 doi: 10.1016/j.eplepsyres.2014.02.015. PMID: 24802296

Clinical prediction guides

Executive functioning and social skills in children with epileptic seizures and non-epileptic seizures.
Levan A, Fegter O, Gale SD
Epilepsy Res 2022 Dec;188:107051. Epub 2022 Nov 4 doi: 10.1016/j.eplepsyres.2022.107051. PMID: 36379123
Artificial intelligence as an emerging technology in the current care of neurological disorders.
Patel UK, Anwar A, Saleem S, Malik P, Rasul B, Patel K, Yao R, Seshadri A, Yousufuddin M, Arumaithurai K
J Neurol 2021 May;268(5):1623-1642. Epub 2019 Aug 26 doi: 10.1007/s00415-019-09518-3. PMID: 31451912
Reliability of reported peri-ictal behavior to identify psychogenic nonepileptic seizures.
Kerr WT, Chau AM, Janio EA, Braesch CT, Le JM, Hori JM, Patel AB, Gallardo NL, Bauirjan J, Allas CH, Karimi AH, Hwang ES, Davis EC, Buchard A, Torres-Barba D, D'Ambrosio S, Al Banna M, Cho AY, Engel J Jr, Cohen MS, Stern JM
Seizure 2019 Apr;67:45-51. Epub 2019 Mar 5 doi: 10.1016/j.seizure.2019.02.021. PMID: 30884437Free PMC Article
Utility of different seizure induction protocols in psychogenic nonepileptic seizures.
Goyal G, Kalita J, Misra UK
Epilepsy Res 2014 Aug;108(6):1120-7. Epub 2014 Apr 8 doi: 10.1016/j.eplepsyres.2014.02.015. PMID: 24802296
The pediatric non-epileptic seizure.
Tamer SK
Indian J Pediatr 1997 Sep-Oct;64(5):671-6. doi: 10.1007/BF02726123. PMID: 10771901

Recent systematic reviews

Utility of serum lactate on differential diagnosis of seizure-like activity: A systematic review and meta-analysis.
Patel J, Tran QK, Martinez S, Wright H, Pourmand A
Seizure 2022 Nov;102:134-142. Epub 2022 Oct 7 doi: 10.1016/j.seizure.2022.10.007. PMID: 36242832
The effectiveness of psychological interventions for children and adolescents with non-epileptic seizures.
Velani H, Gledhill J
Seizure 2021 Dec;93:20-31. Epub 2021 Sep 14 doi: 10.1016/j.seizure.2021.09.006. PMID: 34656015
Psychological and behavioural treatments for adults with non-epileptic attack disorder.
Martlew J, Pulman J, Marson AG
Cochrane Database Syst Rev 2014 Feb 11;2014(2):CD006370. doi: 10.1002/14651858.CD006370.pub2. PMID: 24519702Free PMC Article

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