Reader response: Mortality in patients with psychogenic nonepileptic seizures
Nitin K.Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center (New York, NY)
Submitted July 27, 2020
I read with interest study by Nightscales et al.1 of mortality in patients with psychogenic nonepileptic seizures (PNES) and the accompanying editorial by Giraldez and Lafrance.1,2 In my personal experience, patients with PNES usually carry multiple other diagnostic labels referable to different organ systems. Many of these diagnostic labels fall under the category of somatoform and conversion disorders. Whether the increased mortality seen in patients with PNES is on account of misdiagnoses of some latent cardiovascular, cerebrovascular, or neoplastic disorder as somatoform or conversion disorder with resultant delayed or inappropriate treatment should be investigated. The fact that overall mortality in the PNES group is 2.5 times the general population emphasizes that these patients should continue to remain in close follow up with both their neurologist and primary care physician after a diagnosis of PNES is made.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Nightscales R, McCartney L, Auvrez C, et al. Mortality in patients with psychogenic nonepileptic seizures. Neurology 2002 Epub July 20.
Bruzzone Giraldez MJ, LaFrance WC Jr. Mortality in patients with psychogenic nonepileptic seizures: A wake-up call. Neurology 2020 Epub July 20.
I read with interest study by Nightscales et al.1 of mortality in patients with psychogenic nonepileptic seizures (PNES) and the accompanying editorial by Giraldez and Lafrance.1,2 In my personal experience, patients with PNES usually carry multiple other diagnostic labels referable to different organ systems. Many of these diagnostic labels fall under the category of somatoform and conversion disorders. Whether the increased mortality seen in patients with PNES is on account of misdiagnoses of some latent cardiovascular, cerebrovascular, or neoplastic disorder as somatoform or conversion disorder with resultant delayed or inappropriate treatment should be investigated. The fact that overall mortality in the PNES group is 2.5 times the general population emphasizes that these patients should continue to remain in close follow up with both their neurologist and primary care physician after a diagnosis of PNES is made.
Disclosure
The author reports no relevant disclosures. Contact journal@neurology.org for full disclosures.
References