Recent Advances in Comorbidities of Psychogenic Non-Epileptic Seizures

Shuang LI, Jianhua ZHANG

Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (2) : 303-308.

PDF(599 KB)
Home Journals Acta Academiae Medicinae Sinicae
Acta Academiae Medicinae Sinicae

Abbreviation (ISO4): Acta Academiae Medicinae Sinicae      Editor in chief: Xuetao CAO

About  /  Aim & scope  /  Editorial board  /  Indexed  /  Contact  / 
PDF(599 KB)
Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (2) : 303-308. DOI: 10.3881/j.issn.1000-503X.16056
Review Articles

Recent Advances in Comorbidities of Psychogenic Non-Epileptic Seizures

Author information +
History +

Abstract

Psychogenic non-epileptic seizures are accompanied by motor,behavioral,sensory,and/or cognitive changes,with the clinical manifestations similar to epileptic seizures.This disease is easy to be misdiagnosed and neglected in clinical work.At present,most intervention measures still depend on the experience of clinicians.This article reviews the comorbidities of psychogenic non-epileptic seizures,including mental and cognitive disorders,somatic syndrome,sleep disorders,and epilepsy.This review aims to strengthen the precision of clinical treatment and management of patients with psychogenic non-epileptic seizures and provide more efficient individualized diagnosis and treatment programs for patients.

Key words

psychogenic non-epileptic seizures / comorbidities / individualized diagnosis and treatment

Cite this article

Download Citations
Shuang LI , Jianhua ZHANG. Recent Advances in Comorbidities of Psychogenic Non-Epileptic Seizures[J]. Acta Academiae Medicinae Sinicae. 2025, 47(2): 303-308 https://doi.org/10.3881/j.issn.1000-503X.16056

References

[1]
Bayly J, Carino J, Petrovski S, et al. Time-frequency mapping of the rhythmic limb movements distinguishes convulsive epileptic from psychogenic nonepileptic seizures[J]. Epilepsia, 2013, 54(8):1402-1408.DOI:10.1111/epi.12207.
[2]
Hinchliffe C, Yogarajah M, Tang L, et al. Electroencephalogram connectivity for the diagnosis of psychogenic non-epileptic seizures[J]. Annu Int Conf IEEE Eng Med Biol Soc, 2022,2022:301-304.DOI:10.1109/embc48229.2022.9871277.
[3]
Brown RJ, Reuber M. Psychological and psychiatric aspects of psychogenic non-epileptic seizures(PNES):a systematic review[J]. Clin Psychol Rev, 2016, 45:157-182.DOI:10.1016/j.cpr.2016.01.003.
[4]
LaFrance W, Reuber M, Goldstein L. Management of psychogenic nonepileptic seizures[J]. Epilepsia, 2013, 54(Suppl 1):53-67.DOI:10.1111/epi.12106.
[5]
Ludwig L, Pasman JA, Nicholson T, et al. Stressful life events and maltreatment in conversion(functional neurological)disorder:systematic review and meta-analysis of case-control studies[J]. Lancet Psychiatry, 2018, 5(4):307-320.DOI:10.1016/s2215-0366(18)30051-8.
[6]
Direk N, Kulaksizoglu IB, Alpay K, et al. Using personality disorders to distinguish between patients with psychogenic nonepileptic seizures and those with epileptic seizures[J]. Epilepsy Behav, 2012, 23(2):138-141.DOI:10.1016/j.yebeh.2011.11.013.
[7]
Salinsky M, Evrard C, Storzbach D, et al. Psychiatric comorbidity in veterans with psychogenic seizures[J]. Epilepsy Behav, 2012, 25(3):345-349.DOI:10.1016/j.yebeh.2012.07.013.
[8]
Willment K, Hill M, Baslet G, et al. Cognitive impairment and evaluation in psychogenic nonepileptic seizures:an integrated cognitive-emotional approach[J]. Clin EEG Neurosci, 2015, 46(1):42-53.DOI:10.1177/1550059414566881.
[9]
van der Kruijs SJM, Bodde NMG, Vaessen MJ, et al. Functional connectivity of dissociation in patients with psychogenic non-epileptic seizures[J]. J Neurol Neurosurg Psychiatry, 2012, 83(3):239-247.DOI:10.1136/jnnp-2011-300776.
[10]
Labate A, Cerasa A, Mula M, et al. Neuroanatomic correlates of psychogenic nonepileptic seizures:a cortical thickness and VBM study[J]. Epilepsia, 2012, 53(2):377-385.DOI:10.1111/j.1528-1167.2011.03347.x.
[11]
Teodoro T, Edwards MJ, Isaacs JD. A unifying theory for cognitive abnormalities in functional neurological disorders,fibromyalgia and chronic fatigue syndrome:systematic review[J]. J Neurol Neurosurg Psychiatry, 2018, 89(12):1308-1319.DOI:10.1136/jnnp-2017-317823.
[12]
Kamil SH, Qureshi M, Patel RS. Cognitive behavioral therapy(CBT)in psychogenic non-epileptic seizures(PNES):a case report and literature review[J]. Behav Sci Basel Switz, 2019, 9(2):15.DOI:10.3390/bs9020015.
[13]
Krámská L, Myers L, Hrešková L, et al. Neuropsychological performance and effort in patients diagnosed with psychogenic nonepileptic seizures - descriptive study of a Czech sample[J]. Epilepsy Behav, 2022,128:108584.DOI:10.1016/j.yebeh.2022.108584.
[14]
Mökleby K, Blomhoff S, Malt UF, et al. Psychiatric comorbidity and hostility in patients with psychogenic nonepileptic seizures compared with somatoform disorders and healthy controls[J]. Epilepsia, 2002, 43(2):193-198.DOI:10.1046/j.1528-1157.2002.20901.x.
[15]
Dixit R, Popescu A, Bagić A, et al. Medical comorbidities in patients with psychogenic nonepileptic spells(PNES)referred for video-EEG monitoring[J]. Epilepsy Behav, 2013, 28(2):137-140.DOI:10.1016/j.yebeh.2013.05.004.
[16]
Shepard MA, Silva A, Starling AJ, et al. Patients with psychogenic nonepileptic seizures report more severe migraine than patients with epilepsy[J]. Seizure, 2016, 34:78-82.DOI:10.1016/j.seizure.2015.12.006.
[17]
Ertan D, Aybek S, LaFrance WC, et al. Functional(psychogenic non-epileptic/dissociative)seizures:why and how[J]. J Neurol Neurosurg Psychiatry, 2022, 93(2):144-157.DOI:10.1136/jnnp-2021-326708.
[18]
Latreille V, Dworetzky BA, Baslet G, et al. Sleep disturbances in patients with psychogenic non-epileptic seizures:is it all subjective? A prospective pilot study of sleep-wake patterns[J]. Seizure, 2019, 65:124-128.DOI:10.1016/j.seizure.2019.01.016.
[19]
Latreille V, Baslet G, Sarkis R, et al. Sleep in psychogenic nonepileptic seizures:time to raise a red flag[J]. Epilepsy Behav, 2018, 86:6-8.DOI:10.1016/j.yebeh.2018.07.001.
[20]
Graham CD, Kyle SD. A preliminary investigation of sleep quality in functional neurological disorders:poor sleep appears common,and is associated with functional impairment[J]. J Neurol Sci, 2017, 378:163-166.DOI:10.1016/j.jns.2017.05.021.
[21]
Seneviratne U, Minato E, Paul E. Seizures by the clock:temporal patterns of psychogenic nonepileptic seizures[J]. Epilepsy Behav, 2017, 76:71-75.DOI:10.1016/j.yebeh.2017.08.025.
[22]
Orbach D, Ritaccio A, Devinsky O. Psychogenic,nonepileptic seizures associated with video-EEG-verified sleep[J]. Epilepsia, 2003, 44(1):64-68.DOI:10.1046/j.1528-1157.2003.29302.x.
[23]
Kutlubaev MA, Xu Y, Hackett ML, et al. Dual diagnosis of epilepsy and psychogenic nonepileptic seizures:systematic review and meta-analysis of frequency,correlates,and outcomes[J]. Epilepsy Behav, 2018, 89:70-78.DOI:10.1016/j.yebeh.2018.10.010.
[24]
Liampas A, Markoula S, Zis P, et al. Psychogenic non-epileptic seizures(PNES)in the context of concurrent epilepsy-making the right diagnosis[J]. Acta Epileptol, 2021, 3(1):23.DOI:10.1186/s42494-021-00057-x.
[25]
Duncan R, Graham CD, Oto M, et al. Primary and secondary care attendance,anticonvulsant and antidepressant use and psychiatric contact 5-10 years after diagnosis in 188 patients with psychogenic non-epileptic seizures[J]. J Neurol Neurosurg Psychiatry, 2014, 85(9):954-958.DOI:10.1136/jnnp-2013-306671.
[26]
Kerr WT, Janio EA, Braesch CT, et al. Identifying psychogenic seizures through comorbidities and medication history[J]. Epilepsia, 2017, 58(11):1852-1860.DOI:10.1111/epi.13888.
[27]
Sadan O, Neufeld MY, Parmet Y, et al. Psychogenic seizures:long-term outcome in patients with and without epilepsy[J]. Acta Neurol Scand, 2016, 133(2):145-151.DOI:10.1111/ane.12458.
[28]
Baslet G, Ehlert A, Oser M, et al. Mindfulness-based therapy for psychogenic nonepileptic seizures[J]. Epilepsy Behav, 2020,103:106534.DOI:10.1016/j.yebeh.2019.106534.
[29]
Howlett S, Reuber M. An augmented model of brief psychodynamic interpersonal therapy for patients with nonepileptic seizures[J]. Psychotherapy, 2009, 46(1):125-138.DOI:10.1037/a0015138.
[30]
Carlson P, Nicholson Perry K. Psychological interventions for psychogenic non-epileptic seizures:a meta-analysis[J]. Seizure, 2017, 45:142-150.DOI:10.1016/j.seizure.2016.12.007.
[31]
Goldstein LH, Robinson EJ, Mellers JDC, et al. Cognitive behavioural therapy for adults with dissociative seizures(CODES):a pragmatic,multicentre,randomised controlled trial[J]. Lancet Psychiatry, 2020, 7(6):491-505.DOI:10.1016/s2215-0366(20)30128-0.
[32]
LaFrance WC Jr, Baird GL, Barry JJ, et al. Multicenter pilot treatment trial for psychogenic nonepileptic seizures:a randomized clinical trial[J]. JAMA Psychiatry, 2014, 71(9):997-1005.DOI:10.1001/jamapsychiatry.2014.817.
[33]
Radez J, Crossland T, Johns L. Cognitive behavioural therapy for psychogenic nonepileptic seizures(PNES)in an adult with a learning disability:a case study[J]. Br J Learn Disabil, 2023, 51(4):586-596.DOI:10.1111/bld.12531.
[34]
Sharpe M, Walker J, Williams C, et al. Guided self-help for functional(psychogenic)symptoms[J]. Neurology, 2011, 77(6):564-572.DOI:10.1212/wnl.0b013e318228c0c7.
[35]
Baslet G, Ridlon R, Raynor G, et al. Sustained improvement with mindfulness-based therapy for psychogenic nonepileptic seizures[J]. Epilepsy Behav, 2022,126:108478.DOI:10.1016/j.yebeh.2021.108478.
[36]
LaFrance WC, Alosco ML, Davis JD, et al. Impact of family functioning on quality of life in patients with psychogenic nonepileptic seizures versus epilepsy[J]. Epilepsia, 2011, 52(2):292-300.DOI:10.1111/j.1528-1167.2010.02765.x.
[37]
Milán-Tomás Á, Persyko M, Del Campo M, et al. An overview of psychogenic non-epileptic seizures:etiology,diagnosis and management[J]. Can J Neurol Sci, 2018, 45(2):130-136.DOI:10.1017/cjn.2017.283.
[38]
Kozlowska K, Chudleigh C, Cruz C, et al. Psychogenic non-epileptic seizures in children and adolescents:Part Ⅱ-explanations to families,treatment,and group outcomes[J]. Clin Child Psychol Psychiatry, 2018, 23(1):160-176.DOI:10.1177/1359104517730116.
[39]
Santos Nde O, Benute GR, Santiago A, et al. Psychogenic non-epileptic seizures and psychoanalytical treatment:results[J]. Rev Assoc Medica Bras(1992), 2014, 60(6):577-584.DOI:10.1590/1806-9282.60.06.018.
[40]
LaFrance WC, Keitner GI, Papandonatos GD, et al. Pilot pharmacologic randomized controlled trial for psychogenic nonepileptic seizures[J]. Neurology, 2010, 75(13):1166-1173.DOI:10.1212/wnl.0b013e3181f4d5a9.
[41]
Pintor L, Baillés E, Matrai S, et al. Efficiency of venlafaxine in patients with psychogenic nonepileptic seizures and anxiety and/or depressive disorders[J]. J Neuropsychiatry Clin Neurosci, 2010, 22(4):401-408.DOI:10.1176/jnp.2010.22.4.401.
[42]
Ferreira GE, Abdel-Shaheed C, Underwood M, et al. Efficacy,safety,and tolerability of antidepressants for pain in adults:overview of systematic reviews[J]. BMJ, 2023, 380:e072415.DOI:10.1136/bmj-2022-072415.
[43]
Sadegh AA, Gehr NL, Finnerup NB. A systematic review and meta-analysis of randomized controlled head-to-head trials of recommended drugs for neuropathic pain[J]. PAIN Rep, 2024, 9(2):e1138.DOI:10.1097/PR9.0000000000001138.
[44]
Gazzola DM, Carlson C, Rugino A, et al. Psychogenic nonepileptic seizures and chronic pain:a retrospective case-controlled study[J]. Epilepsy Behav, 2012, 25(4):662-665.DOI:10.1016/j.yebeh.2012.10.008.
[45]
Hill T, Coupland C, Morriss R, et al. Antidepressant use and risk of epilepsy and seizures in people aged 20 to 64 years:cohort study using a primary care database[J]. BMC Psychiatry, 2015,15:1-13.DOI:10.1186/s12888-015-0701-9.
[46]
Sanchez-Barcelo EJ, Rueda N, Mediavilla MD, et al. Clinical uses of melatonin in neurological diseases and mental and behavioural disorders[J]. Curr Med Chem, 2017, 24(35):3851-3878.DOI:10.2174/0929867324666170718105557.
PDF(599 KB)

Accesses

Citation

Detail

Sections
Recommended

/