Phenomenology and diagnoses associated with psychogenic non-epileptic seizures

Abstract

Introduction: Psychogenic non-epileptic seizures (PNES) are seizure resembling behavior without electrical correlates inside
the brain, often having a psychogenic etiology. However, there is a paucity of research into the phenomenology, and hence,
there is frequent diagnostic dilemma. The phenomenology appears to be spread across multiple diagnostic categories in nonspecific
manner. The study aimed at finding the phenomenology and the other diagnoses associated with PNES. Materials and
Methods: 50 consecutive patients presenting to the tertiary psychiatric center of Eastern India were enquired on semi-structured
proforma to assess the phenomenology (including the antecedent events or stressors, ictal details, and the post-ictal stage) and
associated diagnosis. Appropriate diagnostic tools were used to verify the associated diagnoses. Results: The patients of this
sample mostly belonged mostly to low socioeconomic group, females from second decade who were unemployed and had poor
socioeconomic support. They mostly had ongoing stressors, were mute during spells showed non-stereotyped movements of body
parts. Most of them also had other Axis I and Axis II diagnosis of which depression, anxiety, and personality disorder were common.
Conclusion: PNES is a non-specific expression of various underlying psychopathologies, because it is seen most often with other
independently diagnosable psychiatric conditions.