To compare quality of life (QoL) and functional status between psychogenic non-epileptic seizures (PNES) and epileptic seizures (ES).

Studies investigating QoL in adults with epilepsy (AWE) typically focus on seizure control rather than functional status. No studies have explored functional status in PNES.

Adults undergoing VEEG from 2000 to 2003 were invited to participate in a long-term study of functional outcomes. Subjects completed questionnaires assessing demographics, seizure-related factors, QoL using a 10-point Likert scale, highest achieved educational and occupational status, living dependence, and driving status. This analysis compared baseline status between PNES and ES groups. Groups were compared using Pearson’s chi-square, Fisher’s exact, and Wilcoxon rank sum tests. Multivariable models controlled for gender, SSRI and anti-seizure medication use.

The sample included 143 participants (72 PNES, 71 ES), age 36.6±11.5, 64.3% female, monthly seizure frequency 4.0 [2.0, 12.0].  QoL was comparably impaired in PNES and ES (6.2±2.0 vs. 6.7±2.0, p=0.15).  While highest educational status achieved did not differ between groups (PNES 51.6% and 54.8% ES college educated, p=0.71), PNES participants achieved higher occupational status endorsing executive/professional levels (77.6% vs. 53.8%, p=0.023). Few participants lived alone (PNES 11.4% vs. ES 7.4%, p=0.15) and many in both groups were dependent for financial support (PNES 51.5% vs. ES 43.9%, p=0.38). More participants with PNES endorsed current driving (39.7% vs. 23.9%, p=0.048). In multivariable modeling, the odds of achieving a professional occupational level were greater in PNES than ES (OR 3.0 (1.13,7.92), p=0.027). 

QoL is comparably impaired in patients with active PNES and ES, however, functional impairments differ. While PNES and ES experience significant living dependency, AWE experience more limitations related to driving and occupational achievements. Further research is warranted given the lack of data on functional impairments in these populations.