In their article, Syed et al. propose a self-administered screening questionnaire to diagnose psychogenic nonepileptic seizures (PNES). [1] I am a practicing neurologist in India and encounter many patients with PNES due to the low socio-economic conditions. It is difficult to apply these questionnaires in our country because patients have a low education level and are not fully cooperative.
Generally, we diagnose PNES by taking a history but sometimes we advise the use of a cell phone camera by attendants to record the events as these seizures generally occur when other people are present. This method is easily available and does not cost anything. We use brain imaging with routine EEG and occasionally short term (2-3 hours) VEEG when the diagnosis needs confirmation.
We have seen that this type of PNES also varies with cultural background and education levels. This may be due to specific populations mimicking each other. PNES occurs most commonly in young females in our male dominant society. Sexual abuse seems to be the most common cause.
Reference
1. Syed TU, Arozullah AM, Loparo KL, et al. A self-administered screening instrument for psychogenic nonepileptic seizures. Neurology 2009;72;1646-1652.
In their article, Syed et al. propose a self-administered screening questionnaire to diagnose psychogenic nonepileptic seizures (PNES). [1] I am a practicing neurologist in India and encounter many patients with PNES due to the low socio-economic conditions. It is difficult to apply these questionnaires in our country because patients have a low education level and are not fully cooperative.
Generally, we diagnose PNES by taking a history but sometimes we advise the use of a cell phone camera by attendants to record the events as these seizures generally occur when other people are present. This method is easily available and does not cost anything. We use brain imaging with routine EEG and occasionally short term (2-3 hours) VEEG when the diagnosis needs confirmation.
We have seen that this type of PNES also varies with cultural background and education levels. This may be due to specific populations mimicking each other. PNES occurs most commonly in young females in our male dominant society. Sexual abuse seems to be the most common cause.
Reference
1. Syed TU, Arozullah AM, Loparo KL, et al. A self-administered screening instrument for psychogenic nonepileptic seizures. Neurology 2009;72;1646-1652.
Dr. Khandelwal reports no disclosures.