Role of Short Term Video Encephalography with Induction by Verbal Suggestion in Diagnosis of Suspected Paroxysmal Nonepileptic Seizure-Like Symptoms.
Soaham Dilip DesaiDevangi DesaiTrilok JaniPublished in: Epilepsy research and treatment (2016)
Purpose. To determine the diagnostic yield and utility of STVEEG with verbal suggestion in diagnosis of patients presenting with transient unresponsiveness and suspected psychogenic nonepileptiform seizures. Methods. A retrospective analysis of STVEEG records of patients with transient unresponsiveness and suspected PNES between 1 Jan 2009 and 28 Feb 2014 was done. Results. Amongst 155 patients [38 males, 117 females], with mean age 32 [8-67], PNES were identified in 109 [70.3%], focal epilepsy was identified in 24 [15.4%], and actual seizure was recorded in 7 [4.5%]. Nine [5.8%] patients were found to have both epilepsy and PNES. Primary generalized epilepsy was diagnosed in 2 [1.2%]. A diagnosis of other paroxysmal nonepileptiform events [tachyarrhythmia and heart block] was done in 3 [1.9%]. A normal EEG and no inducible episode and hence an uncertain diagnosis at the end of STVEEG were seen in only 17 [10.9%] patients. A STVEEG of approximately one hour duration was able to establish the diagnosis in 138 [89.1%] patients with transient unresponsiveness. Conclusion. STVEEG with verbal suggestion is a useful and cost effective diagnostic test for diagnosis of PNES. It can be a good modality for diagnosis in patients with transient abnormalities in sensorium in the outpatient settings in developing countries.