Differentiating frontal lobe epilepsy from psychogenic nonepileptic seizures.

Patients with psychogenic nonepileptic seizures (PNES) remain one of the most challenging patient populations. The misdiagnosis of PNES is costly to patients, the health care system, and to society. The first step in treatment is proper diagnosis. Video electroencephalography remains the gold standard for PNES diagnosis. Differentiating frontal lobe epilepsy (FLE) from PNES can be difficult; however, clinical findings and laboratory advances are emerging that more clearly establish the diagnosis of PNES. This article provides clues to differentiating FLE from PNES so that neurologists and mental health providers are better equipped to offer treatments for PNES.