Robert D Bolen1, Elizabeth H Koontz2, Paul B Pritchard2. 1. Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, United States. Electronic address: bolen@musc.edu. 2. Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, United States.
Abstract
INTRODUCTION: Both structural and functional abnormalities have been reported in patients with psychogenic nonepileptic events (PNEEs), although no truly consistent abnormalities have been found. METHODS: We retrospectively identified patients discharged from our EMU with video-EEG diagnoses of epileptic seizures, PNEEs, epileptic seizures plus PNEEs, interictal epileptiform abnormalities only, and nondiagnostic admissions. We then collected brain MRI results for analysis. RESULTS: We found significant brain MRI abnormalities in 33.8% of patients with PNEEs, clearly higher than the rate of brain MRI abnormalities in the healthy population. In addition, we found statistically significant differences in the locations of brain MRI abnormalities in patients with epileptic seizures (more frequently temporal) versus PNEEs (more frequently multifocal). CONCLUSION: This multifocal nature of abnormalities in patients with psychogenic nonepileptic events may help to explain the underlying pathophysiology as it relates to psychiatric disorders which are so frequently comorbid with PNEEs.
INTRODUCTION: Both structural and functional abnormalities have been reported in patients with psychogenic nonepileptic events (PNEEs), although no truly consistent abnormalities have been found. METHODS: We retrospectively identified patients discharged from our EMU with video-EEG diagnoses of epileptic seizures, PNEEs, epilepticseizures plus PNEEs, interictal epileptiform abnormalities only, and nondiagnostic admissions. We then collected brain MRI results for analysis. RESULTS: We found significant brain MRI abnormalities in 33.8% of patients with PNEEs, clearly higher than the rate of brain MRI abnormalities in the healthy population. In addition, we found statistically significant differences in the locations of brain MRI abnormalities in patients with epileptic seizures (more frequently temporal) versus PNEEs (more frequently multifocal). CONCLUSION: This multifocal nature of abnormalities in patients with psychogenic nonepileptic events may help to explain the underlying pathophysiology as it relates to psychiatric disorders which are so frequently comorbid with PNEEs.