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Clinical Cases and Reviews in Epilepsy

Stereotypy of psychogenic nonepileptic seizurelike events compared to temporal lobe seizures:
a quantitative analysis of ictal events captured during Video EEG monitoring

Brief report/Clinical case, 20 - 25
doi: 10.11138/ccre/2017.2.1.020
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Abstract
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Objective: The overarching goal of the current study was to study the features of stereotypy in temporal lobe seizures (TLS) and psychogenic nonepileptic seizures (PNES) in four different domains: duration, type, sequence and continuity of ictal behaviours.
Methods: Video-EEG (VEEG) data from 20 TLS patients and 20 PNES patients admitted to the Stanford Epilepsy Center were retrospectively analysed. A priori, a set of 59 possible ictal behaviours was defined. Each behaviour was analysed for its duration, sequence, and continuity using quantified measures.
Results: A total of 138 seizures were analysed (90 PNES, 48 TLS). Median duration of PNES (143 s) was significantly longer than TLS (68 s) (P=0.002), and PNES exhibited greater duration variability (P=0.005). The density of “pauses” within a seizure (time-lag during which ictal behaviours cease) was significantly greater in PNES comparing to TLS (P=0.012). Moreover, the presence of 2 “pauses” during an episode determines a 69% probability of the seizure being non-epileptic, and only a 30% probability of being epileptic.
Conclusion: While different degrees of stereotypy can be seen in TLE seizures and psychogenic seizure-like events, we found that event duration and fluctuating pattern of ictal behaviour (i.e., “on-off” pattern with pauses of behaviour during ictal event) are reliable predictors of an event being psychogenic in etiology.

Vol. 2 (No. 1) 2017 Janaury - December

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    Brigo F., Bragazzi N.L., Nardone R.
    doi: 10.11138/ccre/2017.2.1.001
  2. Psychogenic non-epileptic seizures: an overview on terminology, epidemiology and diagnostic features
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  3. Drug resistant epilepsy in a young male with Cat Eye Syndrome: a case study
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  4. Stereotypy of psychogenic nonepileptic seizurelike events compared to temporal lobe seizures: a quantitative analysis of ictal events captured during Video EEG monitoring
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    doi: 10.11138/ccre/2017.2.1.020
  5. Super-refractory status epilepticus or degenerative encephalopathy with rapid progression? A case report
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  6. Polymicrogyria: the bigger the malformation, the worse the epilepsy, is that true?
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  7. Is genetic aetiology an absolute contraindication for epilepsy surgery? Description of two patients with focal genetic epilepsy who underwent presurgical study
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  8. First clinical experiences with perampanel in adult patients with drug-resistant epilepsy and cognitive impairment
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  11. Axial propriospinal myoclonus misdiagnosed as myoclonic seizures
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  12. Atypical focal ESES/CSWSS: a clinical case
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  1. Stereotypy of psychogenic nonepileptic seizurelike events compared to temporal lobe seizures:
    a quantitative analysis of ictal events captured during Video EEG monitoring

    Vogrig A,, Hsiang J.C., Parvizi J.
    doi: 10.11138/ccre/2017.2.1.020
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