Risk Factors for Diagnostic Delay in Psychogenic Nonepileptic Seizures Among Children and Adolescents

Pediatr Neurol. 2017 Feb:67:71-77. doi: 10.1016/j.pediatrneurol.2016.10.021. Epub 2016 Nov 9.

Abstract

Background: This study aims to analyze a series of pediatric patients with psychogenic nonepileptic seizures (PNES) to establish the diagnostic gap and possible risk factors for the delayed diagnosis in this age group.

Methods: We evaluated all children with PNES documented by video electroencephalography. None had a previous diagnosis of PNES. In total, we included 53 children (interquartile range: seven to 17 years; mean age 12.81 years [S.D. 3.15]; 60.4% girls) who underwent a protocol consisting of neurological and psychiatric interviews.

Results: The average time between seizure onset and referral was 17.76 months (interquartile range: 0.5 to 48 months; S.D. ± 12.62). Earlier age of onset correlated with a later diagnosis (P < 0.001). The late referral group also presented with a history of psychological abuse (P = 0.018).

Conclusion: Youth with PNES represent a diagnostic challenge. Identification of children at risk might lead to earlier diagnosis of PNES.

Keywords: adolescents; children; diagnosis; nonepileptic seizures; psychogenic.

MeSH terms

  • Adolescent
  • Age of Onset
  • Child
  • Child Abuse / psychology
  • Delayed Diagnosis
  • Electroencephalography
  • Female
  • Humans
  • Interview, Psychological
  • Linear Models
  • Male
  • Neurologic Examination
  • Referral and Consultation
  • Risk Factors
  • Seizures / diagnosis*
  • Seizures / epidemiology*
  • Somatoform Disorders / diagnosis*
  • Somatoform Disorders / epidemiology*
  • Time Factors
  • Video Recording