To study the profile and outcomes of patients who were diagnosed with Psychogenic Nonepileptic Seizures(PNES) after Video-EEG monitoring(V-EEG).

A retrospective chart review of all patients 18 or older admitted to our Epilepsy Center from January 2012-January 2017 was performed (n = 480), this excluded those who had been admitted for epilepsy surgery evaluation. The ages ranged from 18-92 years old.  After V-EEG the patients were given the diagnosis of PNES by the Epileptologist, they were told that they do not have epileptic seizures and a Psychiatry consult was obtained. The efficacy was assessed by comparing the seizure frequency at EMU admission and at first follow up visit.

The number of patients found to have PNES was 189(39%). PNES patients without first follow up visit was 80 patients therefore PNES patients with adequate follow up information was 109. The number of PNES patient who improved after V-EEG and delivery of diagnosis was 96 (96/189=50.8%; 96/109=88%). PNES patients who became seizure free after V-EEG and delivery of diagnosis was 62 ( 62/189=32.8%; 62/109=56.9%). The number of PNES patients who had a psychiatric diagnosis on admission was 154 (81.5%). The maximum improvement was seen in patients over the age of 61 years – ages 18-30 years = 47% improved; 31-60 years = 48% improved; 61 years and older = 69% improved. We found that PNES patients 61 years and older had a psychiatric diagnosis in 73% of cases whereas those PNES patients between the ages of 18 to 30 years had a psychiatric diagnosis in 86%.

This study shows the utility of V-EEG and a structured approach to the delivery of diagnosis in patients with PNES. It also indicates that older PNES patients do better.