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Observational Study
Co-morbidities and outcome of childhood psychogenic non-epileptic seizures--an observational study.
- Vikram Singh Rawat, Vikas Dhiman, Sanjib Sinha, Kommu John Vijay Sagar, Harish Thippeswamy, Santosh Kumar Chaturvedi, Shoba Srinath, and Parthasarthy Satishchandra.
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
- Seizure. 2015 Feb 1;25:95-8.
PurposeTo assess the psychiatric diagnoses and outcome in children with psychogenic non-epileptic seizures (PNES).MethodologyThis hospital based observational study was performed on 44 children aged <16 years, who suspected to have psychogenic non-epileptic seizures based on video-EEG, from August 2005 to August 2012. The parameters noted were the psychiatric diagnosis, co-morbidities, management assessment and interventions (pharmacological and psychosocial), number and duration of follow-up visits, symptoms at follow-up, functioning as reflected by involvement in the social and scholastic work.ResultsAll forty four children completed the evaluation. Thirty four children were diagnosed as having PNES and the underlying psychiatric diagnosis was conversion disorder (n=34, 77.3%). Co-morbid psychiatric disorders were present in 17 children (50%). The common co-morbidities were intellectual disability (n=8, 23.5%), specific learning disorder (n=5, 14.7%), and depression (n=5, 14.7%). Co-morbid epilepsy was present in 8 (23.5%) children and family history of epilepsy was present in 10 (29.4%) cases. About 17 of 34 (50.0%) patients had a minimum follow-up of 6 months (13.9 ± 4.8 months). Twenty six children (76.5%) remained symptom free at the follow-up of 9.8 ± 7 months. The remaining 10 children (22.7%) had non-epileptic seizures with underlying diagnosis of Attention Deficit Hyperactivity Disorder (ADHD), gratification disorder and other physiological conditions.ConclusionsConversion disorder is a common diagnosis underlying psychogenic non-epileptic seizures. Outcome was good in 76.5% children with PNES. A multidisciplinary approach is needed in the diagnosis and management of PNES.Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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