Clinical characteristics of patients with refractory non-epileptic seizures
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Published version
Date
2024-04-19
Authors
Fullam, Sarah
Costello, Daniel J.
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Published Version
Abstract
Objectives: This incidence of non-epileptic seizures (NES) is estimated at 1–35 per 100,000 population. While many patients achieve remission, a significant fraction of patients have a poor prognosis despite optimal interventions. This study reports on the characteristics of patients with refractory NES diagnosed and treated at a comprehensive epilepsy centre.
Methods: A retrospective review of admissions to the Epilepsy Monitoring Unit identified patients diagnosed with NES over a 6-year period. Patients with refractory NES were identified through review of medical files. A diagnosis of refractory NES was assigned when patients experienced ongoing NES at least 1 year after diagnostic video-EEG monitoring. Data pertaining to predisposing, precipitating and perpetuating factors was collected on all patients and a comparative analysis was conducted between refractory and non-refractory cases.
Results: 66 patients with NES were identified, 35% were deemed refractory. There was no significant difference amongst predisposing factors between the groups. Psychosocial adversity and a clear precipitant proximate to the onset of NES were significantly more common in the refractory cohort. Unemployment at time of diagnosis was a significant perpetuating factor associated with poor outcome.
Conclusion: This study provides insight into the features associated with refractory NES and may serve to improve prognostication and management in this disabling condition.
Description
Keywords
Non-epileptic seizures , Refractory , Clinical features
Citation
Fullam, S. and Costello, D.J. (2024) ‘Clinical characteristics of patients with refractory non-epileptic seizures’, Epilepsy & Behavior, 155, 109783. Available at: https://doi.org/10.1016/j.yebeh.2024.109783.