Patient Questionnaires May Help Separate PNES from Epilepsy

Telling the difference between epilepsy and psychogenic non-epileptic seizures (PNES) has always been a challenge, especially in low-resource clinical settings in which video-electroencephalography (EEG) monitoring is not available. Patient questionnaires may help differentiate the 2 conditions, suggests a recent study.

• Investigators gave adult patients and eyewitnesses questionnaires that discussed subjective experiences and vulnerabilities, including signs, symptoms, and risk factors.
• They also calculated specificity and sensitivity for each measured variable, comparing the responses of patients and eyewitnesses to the final diagnosis.
• The study generated 28 useful patient questionnaires, including 17 from patients who had PNES and 11 who had epileptic seizures.
• The analysis uncovered 7 variables that had both high sensitivity and specificity scores, and 5 of these markers were found to be statistically significant diagnostic predictors.
• The most indicative items on the questionnaires included head injury, physical abuse, chronic fatigue, heart racing, and tingling or numbness.
• The analysis also yielded 16 useful eyewitness questionnaires, which found side-to-side head movements and closed eyes as statistically significant markers.

​Patients’ and caregivers’ contributions for differentiating epileptic from psychogenic nonepileptic seizures. Value and limitations of self-reporting questionnaires: A pilot study. Seizure. 2017;53:66-71. DOI: http://dx.doi.org/10.1016/j.seizure.2017.11.001.

Telling the difference between epilepsy and psychogenic non-epileptic seizures (PNES) has always been a challenge, especially in low-resource clinical settings in which video-electroencephalography (EEG) monitoring is not available. Patient questionnaires may help differentiate the 2 conditions, suggests a recent study.

• Investigators gave adult patients and eyewitnesses questionnaires that discussed subjective experiences and vulnerabilities, including signs, symptoms, and risk factors.
• They also calculated specificity and sensitivity for each measured variable, comparing the responses of patients and eyewitnesses to the final diagnosis.
• The study generated 28 useful patient questionnaires, including 17 from patients who had PNES and 11 who had epileptic seizures.
• The analysis uncovered 7 variables that had both high sensitivity and specificity scores, and 5 of these markers were found to be statistically significant diagnostic predictors.
• The most indicative items on the questionnaires included head injury, physical abuse, chronic fatigue, heart racing, and tingling or numbness.
• The analysis also yielded 16 useful eyewitness questionnaires, which found side-to-side head movements and closed eyes as statistically significant markers.

​Patients’ and caregivers’ contributions for differentiating epileptic from psychogenic nonepileptic seizures. Value and limitations of self-reporting questionnaires: A pilot study. Seizure. 2017;53:66-71. DOI: http://dx.doi.org/10.1016/j.seizure.2017.11.001.

Telling the difference between epilepsy and psychogenic non-epileptic seizures (PNES) has always been a challenge, especially in low-resource clinical settings in which video-electroencephalography (EEG) monitoring is not available. Patient questionnaires may help differentiate the 2 conditions, suggests a recent study.

• Investigators gave adult patients and eyewitnesses questionnaires that discussed subjective experiences and vulnerabilities, including signs, symptoms, and risk factors.
• They also calculated specificity and sensitivity for each measured variable, comparing the responses of patients and eyewitnesses to the final diagnosis.
• The study generated 28 useful patient questionnaires, including 17 from patients who had PNES and 11 who had epileptic seizures.
• The analysis uncovered 7 variables that had both high sensitivity and specificity scores, and 5 of these markers were found to be statistically significant diagnostic predictors.
• The most indicative items on the questionnaires included head injury, physical abuse, chronic fatigue, heart racing, and tingling or numbness.
• The analysis also yielded 16 useful eyewitness questionnaires, which found side-to-side head movements and closed eyes as statistically significant markers.

​Patients’ and caregivers’ contributions for differentiating epileptic from psychogenic nonepileptic seizures. Value and limitations of self-reporting questionnaires: A pilot study. Seizure. 2017;53:66-71. DOI: http://dx.doi.org/10.1016/j.seizure.2017.11.001.