Details

Autor(en) / Beteiligte

• van Ool, Jans S.
• Haenen, Alexandra I.
• Snoeijen-Schouwenaars, Francesca M.
• Aldenkamp, Albert P.
• Hendriksen, Jos G.M.
• Schelhaas, H. Jurgen
• Tan, In Y.
• Lazeron, Richard H.C.
• Bodde, Nynke M.G.

Titel

Psychogenic nonepileptic seizures in adults with epilepsy and intellectual disability: A neglected area

Ist Teil von

• Seizure (London, England), 2018-07, Vol.59, p.67-71

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2018

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •Diagnostic challenges can form a barrier for reliable diagnosis of PNES in ID.•PNES may be underdiagnosed in a population of ID patients with epilepsy.•Women with mild/moderate ID and psychosocial difficulties seem vulnerable for PNES.•Stress-related triggers were recognised in a large majority by daily caregivers.•A reinforced behavioural pattern should be considered as subcategory of PNES. To describe the main characteristics of psychogenic nonepileptic seizures (PNES) in adults with epilepsy and intellectual disability (ID), and to analyse the differences regarding psychosocial functioning, epilepsy severity and ID between patients with PNES and a control group without PNES. Medical records of adults with ID and epilepsy living at an epilepsy care facility (N = 240) were screened for PNES and evaluated by a neurologist. A control group consisting of patients with epilepsy and ID, without PNES, was matched according to age, sex and level of ID. Characteristics of PNES and epilepsy were provided by the subject’s nursing staff or retrieved from patient charts, psychosocial data were collected by standardised questionnaires and level of ID was individually assessed using psychometric instruments. The point prevalence of PNES was 7.1%. The patients with PNES (n = 15) were most often female and had a mild or moderate level of ID. Compared to controls, they showed more depressive symptoms, experienced more negative life events and had more often an ID discrepancy (ID profile with one domain particularly more impaired than another). Stress-related triggers were recognised in a large majority by the nursing staff. PNES appears to be a relatively rare diagnostic entity among inpatients with both epilepsy and ID. However, the complexity of diagnosing PNES in this population, and the similarities in stress-related triggers for PNES in patients with and without ID, suggest that PNES may be underdiagnosed in the ID population. Diagnostic challenges of PNES and, as subcategory, reinforced behavioural patterns are discussed.