Differentiation between epileptic seizures and functional seizures in the emergency department of hospitals in Espírito Santo
DOI:
https://doi.org/10.11606/issn.1679-9836.v104i1e-224895Keywords:
Emergency, Psychogenic Nonepileptic Seizures, Epilepsy, SeizureAbstract
Functional Seizures (FS) involve paroxysmal changes in behavior that resemble epileptic seizures; however, there is no electrophysiological correlation or clinical evidence of epilepsy. Nevertheless, clearly distinguishing FS is often a challenge and may be confused with true epileptic seizures in clinical practice. The present study assesses the knowledge and ability of physicians in the emergency department of hospitals in Espírito Santo to differentiate Functional Seizures (FS). The aim is to elucidate the difficulty in formulating an appropriate diagnostic hypothesis. The prospective study included a convenience sample, in which medical professionals responded to an individual questionnaire with 8 questions about the distinguishing characteristics of seizures. Our data show that professionals demonstrated difficulty in differentiating epileptic seizures from FS, which negatively impacts both diagnostic accuracy and the proper management of cases.
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Popkirov S, Asadi-Pooya AA, Duncan R, Gigineishvili D, Hingray C, Kanner AM, et al. The aetiology of psychogenic non-epileptic seizures: risk factors and comorbidities. Epileptic Disord. 2019;21(6):529-47. Doi: https://doi.org/10.1684/epd.2019.1107.
Operto FF, Coppola G, Mazza R, Pastorino GMG, Campanozzi S, Margari L, et al. Psychogenic nonepileptic seizures in pediatric population: a review. Brain Behav. 2019;9(12):e01406. Doi: https://doi.org/10.1002/brb3.1406.
Benbadis SR, Allen Hauser W. An estimate of the prevalence of psychogenic non-epileptic seizures. Seizure. 2000;9(4):280-1. Doi: https://doi.org/10.1053/seiz.2000.0409
Duncan R, Razvi S, Mulhern S. Newly presenting psychogenic nonepileptic seizures: incidence, population characteristics, and early outcome from a prospective audit of a first seizure clinic. Epilepsy Behav. 2011;20(2):308-11. Doi: https://doi.org/10.1016/j.yebeh.2010.10.022.
Reuber M. Psychogenic nonepileptic seizures: answers and questions. Epilepsy Behav. 2008;12(4):622-35. Doi: https://orcid.org/10.1016/j.yebeh.2007.11.006.
Reif PS, Willems LM, Strzelczyk A, Klein KM, Rosenow F. Psychogene nichtepileptische Anfälle : Differenzialdiagnostische Merkmale [Psychogenic non epileptic seizures: Differential diagnostic features]. Herzschrittmacherther Elektrophysiol. 2018;29(2):155-60. Doi: https://orcid.org/10.1007/s00399-018-0557-z.
Holtkamp M, Othman J, Buchheim K, Meierkord H. Diagnosis of psychogenic nonepileptic status epilepticus in the emergency setting. Neurology. 2006;66(11):1727-9. Doi: https://orcid.org/10.1212/01.wnl.0000218299.15988.9d.
LaFrance WC Jr, Benbadis SR. Avoiding the costs of unrecognized psychological nonepileptic seizures. Neurology. 2006;66(11):1620-1. Doi: https://doi.org/10.1212/01.wnl.0000224953.94807.be
Reuber M, Fernández G, Bauer J, Helmstaedter C, Elger CE. Diagnostic delay in psychogenic nonepileptic seizures. Neurology. 2002;58(3):493-5. Doi: https://orcid.org/10.1212/wnl.58.3.493
LaFrance WC Jr, Baker GA, Duncan R, Goldstein LH, Reuber M. Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach: a report from the International League Against Epilepsy Nonepileptic Seizures Task Force. Epilepsia. 2013;54(11):2005-18. Doi: https://doi.org/10.1111/epi.12356.
Reuber M, Mayor R. Recent progress in the understanding and treatment of nonepileptic seizures. Curr Opin Psychiatry. 2012;25(3):244-50. Doi: https://doi.org/10.1097/YCO.0b013e3283523db6.
Benbadis SR, Allen Hauser W. An estimate of the prevalence of psychogenic non-epileptic seizures. Seizure. 2000;9(4):280-1. Doi: https://doi.org/10.1053/seiz.2000.0409.
Doss RC, LaFrance WC Jr. Psychogenic non-epileptic seizures. Epileptic Disord. 2016;18(4):337-43. Doi: https://doi.org/10.1684/epd.2016.0873.
Fisher RS, Van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005;46(4):470-2. Doi: https://doi.org/10.1111/j.0013-9580.2005.66104.x
Huff JS, Murr N. Psychogenic Nonepileptic Seizures. 2022 May 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
Asadi-Pooya AA, Sperling MR. Epidemiology of psychogenic nonepileptic seizures. Epilepsy Behav. 2015;46:60-65. Doi: https://doi.org/10.1016/j.yebeh.2015.03.015.
Beimer NJ, LaFrance WC Jr. Evaluation and Treatment of Psychogenic Nonepileptic Seizures. Neurol Clin. 2022;40(4):799-820. Doi: https://doi.org/10.1016/j.ncl.2022.03.017.
Lopez MR, LaFrance WC. Treatment of Psychogenic Nonepileptic Seizures. Curr Neurol Neurosci Rep. 2022;22(8):467-74. Doi: https://doi.org/10.1007/s11910-022-01209-3.
Capovilla G, Beccaria F, Beghi E, Minicucci F, Sartori S, Vecchi M. Treatment of convulsive status epilepticus in childhood: recommendations of the Italian League Against Epilepsy. Epilepsia. 2013;54 Suppl 7:23-34. Doi: https://doi.org/10.1111/epi.12307.
Fiszman A, Alves-Leon SV, Nunes RG, D'Andrea I, Figueira I. Traumatic events and posttraumatic stress disorder in patients with psychogenic nonepileptic seizures: a critical review. Epilepsy Behav. 2004;5(6):818-25. Doi: https://doi.org/10.1016/j.yebeh.2004.09.002.
Riviello JJ. Classification of seizures and epilepsy. Curr Neurol Neurosci Rep. 2003;3(4):325-31. Doi: https://doi.org/10.1007/s11910-003-0010-4.
Scott DF. Recognition and diagnostic aspects of nonepileptic seizures. In: Riley TL Roy A. (eds). Pseudoseizures. Baltimore: Williams & Wilkins, 2008. p.21-34.
Perez DL, LaFrance WC Jr. Nonepileptic seizures: an updated review. CNS Spectr. 2016;21(3):239-46. Doi: https://doi.org/10.1017/S109285291600002X.
Ferlisi M, Hocker S, Grade M, Trinka E, Shorvon S; International Steering Committee of the StEp Audit. Preliminary results of the global audit of treatment of refractory status epilepticus. Epilepsy Behav. 2015;49:318-24. Doi: https://doi.org/10.1016/j.yebeh.2015.04.010.
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