PNES Recovery after Surgery: an unusual evolution of PNES

Psychogenic non-epileptic seizures (PNES) are paroxysmal events that resemble clinical signs and symptoms of epileptic seizures (ES), but are not associated with ictal epileptiform abnormalities in the EEG pattern. The neurobiological theory assumes that an organic cause may lead to an interruption of neuronal pathways assigned to control, affecting the subject’s ability to be oriented in space and time and to be in command of his/her actions. The case describes the history of an adolescent with lesional temporal lobe epilepsy (TLE) and PNES. PNES were correlated with long periods of discontinuation of the normal relationship with the external environment, automatic writing in a state of partial impairment of consciousness and a slow return to normality. After the surgical removal of a right temporal lobe dysplasia, along with a large decrease in ES, PNES completely disappeared. This type of evolu-Clinical Cases and Reviews in Epilepsy 2016; 1(2):149-154 149 tion is unusual and in contrast with previous literature data showing the onset of PNES after brain surgery. The history of this case could be in line with a neurobiological basis of the onset of some types of PNES, although further studies with functional and structural neuroimaging are needed to confirm our hypothesis