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Psychogenic, Epileptic Seizures Distinguished in Three Studies

Eye opening, age, sex and health history lend clues to seizure type

MONDAY, June 12 (HealthDay News) -- Three studies in the June 13 issue of Neurology may help identify the nearly 30 percent of patients diagnosed with epilepsy who actually have psychogenic nonepileptic seizures (PNES).

Steve Chung, M.D., and colleagues from St. Joseph's Hospital and Medical Center in Phoenix, found after video monitoring patients with both disorders that most with PNES closed their eyes during seizures, while most with epilepsy kept their eyes open.

While PNES are thought to occur primarily in younger female patients, Roderick Duncan, M.D., Ph.D., of Southern General Hospital in Glasgow, Scotland, and colleagues found that a subset of older patients can have the disease and are predominately male with a history of traumatic health-related problems.

Martin Holtkamp, M.D., of the Charite-Universitatsmedizin in Berlin, Germany, and colleagues showed that patients with psychogenic nonepileptic status epilepticus in the emergency room tended to be "younger, had port systems implanted more frequently, received higher doses of benzodiazepines until seizure termination or respiratory failure, and had lower serum creatine kinase levels."

"Patients pay a price physically, socially, and financially as long as their PNES remain undiagnosed and improperly treated," states an accompanying editorial. "The three studies in this issue make a major contribution to helping raise the clinicians' suspicion and thereby to recognize PNES."

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