Neurosciences Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
Neurosciences Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
Seizure. 2018 Jul;59:1-4. doi: 10.1016/j.seizure.2018.04.017. Epub 2018 Apr 25.
The aim of the current study was to investigate the long-term outcome of patients with psychogenic nonepileptic seizures (PNES) and factors potentially associated with their outcome in Iran.
We investigated all patients with PNES admitted to the epilepsy monitoring unit at the Shiraz Comprehensive Epilepsy Center from 2008 through 2013. Patients included in this study had a confirmed diagnosis of PNES. In a phone call interview to the patients in December 2017, we obtained the following information: seizure outcome (seizure-free during the past 12 months or not), history of receiving any psychotherapy after confirming their diagnosis in the past, and number of psychotherapy sessions the patient had received.
Eighty-six patients (54 females and 32 males) met the inclusion criteria. Seventy-four (86%) patients did not receive appropriate psychotherapy. Forty-seven (54.7%) patients were seizure-free during the past 12 months. Age at onset (P = 0.02), education (P = 0.01), and taking psychiatric drugs (P = 0.007) were associated with this outcome.
Resources to treat patients with PNES are limited in Iran; however, more than half of the patients became free of seizures. Lower education, comorbid psychiatric problems, and a later age at the onset of seizures may affect the seizure outcome in patients with PNES. Well-designed multi-center cross-cultural long-term studies should address factors associated with outcome in patients with PNES, considering that seizure frequency should not be the only outcome measure.
本研究旨在调查伊朗精神性非癫痫性发作（PNES）患者的长期预后及其预后相关因素。
我们调查了 2008 年至 2013 年期间在设拉子综合癫痫中心癫痫监测病房住院的所有 PNES 患者。本研究纳入的患者均经确诊为 PNES。在 2017 年 12 月对患者进行电话访谈，获取以下信息：发作结局（过去 12 个月无发作或有发作）、在过去确诊后是否接受过任何心理治疗以及接受过的心理治疗次数。
86 例患者（54 例女性和 32 例男性）符合纳入标准。74 例（86%）患者未接受适当的心理治疗。47 例（54.7%）患者在过去 12 个月无发作。发病年龄（P=0.02）、教育程度（P=0.01）和服用精神科药物（P=0.007）与该结局相关。
伊朗治疗 PNES 患者的资源有限，但超过一半的患者发作得到控制。较低的教育程度、合并精神科问题和较晚的发病年龄可能影响 PNES 患者的发作结局。应开展多中心、跨文化的长期研究，明确影响 PNES 患者预后的因素，因为发作频率不应是唯一的结局指标。
