1. Psychogenic nonepileptic seizures in adults with epilepsy and intellectual disability: A neglected area.
- Author
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van Ool JS, Haenen AI, Snoeijen-Schouwenaars FM, Aldenkamp AP, Hendriksen JGM, Schelhaas HJ, Tan IY, Lazeron RHC, and Bodde NMG
- Subjects
- Adult, Aged, Cross-Sectional Studies, Diagnosis, Differential, Epilepsy diagnosis, Epilepsy epidemiology, Epilepsy therapy, Female, Humans, Intellectual Disability diagnosis, Intellectual Disability epidemiology, Intellectual Disability therapy, Male, Middle Aged, Psychophysiologic Disorders epidemiology, Psychophysiologic Disorders therapy, Residential Facilities, Seizures epidemiology, Seizures therapy, Severity of Illness Index, Stress, Psychological complications, Stress, Psychological epidemiology, Young Adult, Epilepsy complications, Intellectual Disability complications, Psychophysiologic Disorders complications, Psychophysiologic Disorders diagnosis, Seizures complications, Seizures diagnosis
- Abstract
Purpose: To describe the main characteristics of psychogenic nonepileptic seizures (PNES) in adults with epilepsy and intellectual disability (ID), and to analyse the differences regarding psychosocial functioning, epilepsy severity and ID between patients with PNES and a control group without PNES., Methods: Medical records of adults with ID and epilepsy living at an epilepsy care facility (N = 240) were screened for PNES and evaluated by a neurologist. A control group consisting of patients with epilepsy and ID, without PNES, was matched according to age, sex and level of ID. Characteristics of PNES and epilepsy were provided by the subject's nursing staff or retrieved from patient charts, psychosocial data were collected by standardised questionnaires and level of ID was individually assessed using psychometric instruments., Results: The point prevalence of PNES was 7.1%. The patients with PNES (n = 15) were most often female and had a mild or moderate level of ID. Compared to controls, they showed more depressive symptoms, experienced more negative life events and had more often an ID discrepancy (ID profile with one domain particularly more impaired than another). Stress-related triggers were recognised in a large majority by the nursing staff., Conclusion: PNES appears to be a relatively rare diagnostic entity among inpatients with both epilepsy and ID. However, the complexity of diagnosing PNES in this population, and the similarities in stress-related triggers for PNES in patients with and without ID, suggest that PNES may be underdiagnosed in the ID population. Diagnostic challenges of PNES and, as subcategory, reinforced behavioural patterns are discussed., (Copyright © 2018 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2018
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