Psychogenic non-epileptic seizures in pediatric neurosurgical patients with drug-resistant epilepsy

Abstract

Background . Psychogenic non-epileptic seizures are episodes involving changes in motor activity, emotions, sensations, or actions that resemble epileptic seizures but are not accompanied by epileptiform changes on the electroencephalogram. Objective . To study the frequency and characteristics of psychogenic non-epileptic seizures (PNES) in paediatric neurosurgical patients with drug-resistant epilepsy (DRE). Design and methods . This is a single-centre, retrospective, uncontrolled, open-label observational study-part of an assignment of the M0H of the RF No.126020916808-7. All patients in the paediatric neurosurgery department diagnosed with DRE were included over a one-year period. The clinical and sociodemographic characteristics of DRE in the paediatric neurosurgery department, as well as the frequency and characteristics of PNES among patients in the neurosurgery department, were studied. Results . In total, 58 children diagnosed with epilepsy were hospitalised in 2021. Group1 included 56 patients of both sexes, DRE without PNES; the mean age was 9.5±0.6 years. The gender ratio was boysto-girls = 1:1,2. The mean age at epilepsy onset was 4.3±0.62 years. Epilepsy onset before 3 years of age was observed in 27 children, of whom 24 had onset before 1 year. 11 children had onset between 3 and 7 years, 12 between 8 and 11 years, and 4 between 12 and 18 years. PNES were detected in 2 patients in Group2, with a boys-to-girls ratio = 1:1. A clinical example of PNES diagnosis in a 16-year-old girl with DRE is presented. Conclusion . Psychogenic non-epileptic seizures occurred in 3,5 % of children with epilepsy in a neurosurgical hospital. The gold standard for diagnosis is neurophysiological examination demonstrating absence of epileptiform activity during a seizure.