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De novo psychogenic nonepileptic attacks after adult epilepsy surgery: An underestimated entity
Author(s) -
Markoula Sofia,
Tisi Jane,
Foong Jacqueline,
Duncan John S.
Publication year - 2013
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12404
Subject(s) - epilepsy , psychogenic disease , epilepsy surgery , medicine , neurosurgery , neurology , psychosis , comorbidity , cohort , psychiatry , pediatrics , surgery
Summary We retrospectively assessed all patients in a large cohort of patients with epilepsy surgery at the N ational H ospital for N eurology and N eurosurgery ( NHNN ) over 12 years, to identify patients with postoperative psychogenic nonepileptic attacks ( PNEA ). Twenty‐nine patients (23 women) were identified of a total of 790 patients, a frequency of 3.7%. Female gender and presurgical psychiatric diagnosis, other than psychosis, were significant risk factors for PNEA development. In female patients with a preoperative psychiatric diagnosis the chance of developing PNEA after epilepsy surgery was 8.5%. PNEA developed between 2 weeks and 10 years after epilepsy surgery, independently of outcome of epileptic seizures. In most cases, PNEA differed from the present or past epileptic seizures, and motor symptoms were the most common manifestations. Seizures after epilepsy surgery should be carefully evaluated. Physicians should consider the possibility of PNEA , especially in female patients with preoperative psychiatric comorbidity developing “atypical” seizures with motor manifestations postoperatively, even many years after epilepsy surgery.