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    Factors affecting long-term prognosis in adult patients with psychogenic non-epileptic seizures
    (Literatura Medica, 2024) Turksever, Meliha; Guldiken, Baburhan; Ozkan, Hulya; Cakar, Merve Melodi
    Background and purpose - Among epileptic patients who are monitored using the video-electroencephalography monitoring (VEM) technique, in some patients a psychogenic non-epileptic seizure (PNES) can be identified as a definitive diagnosis. The long-term prognosis of these patients is not well known. In this study, we aimed to determine the factors that affect the prognosis of PNES. Methods - Forty-one PNES patients diagnosed using VEM between 2012 and 2022 were questioned about their PNES frequencies in the last 12 months. According to their semiological characteristics, PNES types were divided into motor and non-motor seizures. The effects of clinical characteristics (e.g. age, gender, marital status, education level and PNES type) on the prognoses were identified. Results - Twenty-one PNES patients (51.2%) had long-term seizure freedom after VEM. Thirteen of them (31.7%) entered the seizure-free period immediately after VEM, and the other eight (19.5%) continued suffering from PNES for several years and became seizure free in the last 12 months. In the poor-prognosis group, female cases showed worse prognoses than male cases. The prognoses of motor and non-motor PNES types did not show significant differences. Conclusion - This study showed that 51.2% of the PNES patients examined had long-term seizure freedom and that female patients had worse prognoses than male patients.
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    Latency of epileptic and psychogenic nonepileptic seizures
    (Assoc Arquivos Neuro- Psiquiatria, 2023) Ozkan, Hulya; Turksever, Meliha; Guldiken, Baburhan; Sut, Necdet
    Background Due to their semiological similarities, psychogenic nonepileptic seizures (PNESs) can occasionally hardly be differentiated from epileptic seizures (ESs), and long-term video-electroencephalographic monitoring (VEM) is needed for the differential diagnosis.Objective To investigate the time of the first clinical event and its distribution on the days of VEM in ES and PNES patients.Methods In total, a consecutive series of 48 PNES and 51 ES patients matched for gender and age were retrospectively and consecutively evaluated. The time distribution of the seizures during the day was noted. Seizure latency was determined as the time in hours from the start of the video-electroencephalographic recording to the first clinical event.Results The seizure latency was significantly shorter in PNES patients compared to ES patients ( p < 0.001). Seventy-two percent of PNES patients and 49.1% of ES patients had their first seizure in the 24 hours of video-EEG recording ( p = 0.023). Recording longer than 48 hours was required for 12.5% of PNES patients and 37.3% of ES patients ( p = 0.006). While ESs were almost evenly distributed throughout the day, most PNESs occurred during the evening hours ( p = 0.011).Conclusion We observed that the PNESs appeared earlier than the ESs in the VEM and were concentrated during daylight hours. Although not strictly reliable, seizure latency can contribute to the differential diagnosis of ES and PNES.