Asadi-Pooya Ali A, Homayoun Maryam
Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
Neurol Sci. 2020 Aug;41(8):2143-2146. doi: 10.1007/s10072-020-04315-7. Epub 2020 Mar 4.
We investigated medical comorbidities in patients with psychogenic non-epileptic seizures (PNES). We hypothesized that these patients commonly have significant medical comorbidities.
In this retrospective study, all patients with PNES, who were diagnosed at Shiraz Comprehensive Epilepsy Center, Iran, from 2008 until 2019, were investigated. Age, gender, age at seizure onset, seizure semiology, and characteristics, known medical (organic) comorbidities reported by the patients and video-electroencephalography recordings of all patients were registered routinely.
During the study period, 272 patients with PNES-only had the inclusion criteria and were studied. Sixty-five patients (24%) reported having a medical (organic) comorbidity. The most commonly reported medical comorbidity was thyroid disorder. Age at onset (OR: 1.058; 95% CI: 1.026-1.090; p = 0.0001), duration of disease before the diagnosis (OR: 1.071; 95% CI: 1.025-1.119; p = 0.002), and sex (female) (OR: 1.97; 95% CI: 1.016-3.834; p = 0.04) were significantly associated with having medical comorbidities.
While we did not have a control group to provide the number and type of medical problems that are expected in the general population, and therefore our results should be interpreted with caution, we had some intriguing observations. About one quarter of patients with PNES reported having medical comorbidities. The exact nature of the relationship between medical illnesses and PNES is not clear; however, hypothetically they could have a complex relationship. This study provides valuable information on the frequency and nature of medical comorbidities in patients with PNES and opens new horizons for future research.
我们调查了精神性非癫痫性发作（PNES）患者的合并症。我们假设这些患者通常存在显著的合并症。
在这项回顾性研究中，对2008年至2019年期间在伊朗设拉子综合癫痫中心被诊断为PNES的所有患者进行了调查。常规记录患者的年龄、性别、发作起始年龄、发作症状学和特征、患者报告的已知合并症（器质性）以及所有患者的视频脑电图记录。
在研究期间，仅272例PNES患者符合纳入标准并接受研究。65例患者（24%）报告有合并症（器质性）。最常报告的合并症是甲状腺疾病。发作起始年龄（OR：1.058；95%CI：1.026 - 1.090；p = 0.0001）、诊断前疾病持续时间（OR：1.071；95%CI：1.025 - 1.119；p = 0.002）和性别（女性）（OR：1.97；95%CI：1.016 - 3.834；p = 0.04）与合并症显著相关。
虽然我们没有对照组来提供一般人群中预期的医疗问题的数量和类型，因此我们的结果应谨慎解释，但我们有一些有趣的观察结果。约四分之一的PNES患者报告有合并症。疾病与PNES之间关系的确切性质尚不清楚；然而，假设它们可能存在复杂的关系。本研究提供了关于PNES患者合并症的频率和性质的有价值信息，并为未来研究开辟了新的视野。
