Departments of Neurology.
Pediatrics, Emory University School of Medicine, Atlanta, GA.
Neurologist. 2022 May 1;27(3):100-105. doi: 10.1097/NRL.0000000000000378.
Patients with psychogenic nonepileptic seizures (PNES) can be semiologically dichotomized into those with hyperkinetic and those with paucikinetic events. The objective of this study was to compare characteristics of patients with diverse phenomenology and their caregivers to evaluate for differences that could inform about disease nosology.
Patients and caregivers monitored at the Epilepsy Monitoring Unit completed surveys about sociodemographic and disease characteristics, treatment and health care utilization, physical and psychosocial impact, and epilepsy knowledge. Patients were classified into hyperkinetic versus paucikinetic based on their recorded events. Comparison of the 2 populations was performed using Student t test for continuous variables and Fischer exact test for categorical variables.
Forty-three patients with Epilepsy Monitoring Unit confirmed PNES and 28 caregivers were enrolled. Patients with hyperkinetic events were more commonly non-White patients and necessitated greater caregiving time. Otherwise, no statistically significant differences were seen between the 2 semiologically diverse groups of patients and caregivers in their sociodemographic (age, sex, employment, income, marital, and education) and disease (age of onset, duration, seizures frequency) characteristics, treatment (number of antiseizure medications before diagnosis, side effects) and health care utilization (emergency room visits, hospitalizations, clinic visits), physical (injuries) and psychosocial (depression, anxiety, quality of life, stigma, burden) characteristics, nor in their knowledge about seizures.
Hyperkinetic events were more frequently encountered in non-White patients and required more caregiving time. Further research is required to elucidate if phenomenological dichotomy of PNES can inform about their nosological basis, and if it can guide treatment and define prognosis.
心因性非癫痫性发作（PNES）患者可根据其发作时的运动表现分为高动能发作和低动能发作。本研究旨在比较不同表现患者及其照料者的特征，评估其对疾病分类的影响。
在癫痫监测病房监测的患者及其照料者完成了关于社会人口学和疾病特征、治疗和医疗保健利用、身体和心理社会影响以及癫痫知识的问卷调查。根据记录的发作情况，将患者分为高动能组和低动能组。采用 t 检验比较连续变量，采用 Fisher 确切检验比较分类变量。
共纳入 43 例经癫痫监测病房证实的 PNES 患者及其 28 名照料者。高动能发作患者更常见于非白人患者，需要更多的照料时间。否则，两组在社会人口学（年龄、性别、职业、收入、婚姻和教育）和疾病（发病年龄、病程、发作频率）特征、治疗（诊断前使用的抗癫痫药物数量、副作用）和医疗保健利用（急诊就诊、住院、就诊次数）、身体（受伤）和心理社会（抑郁、焦虑、生活质量、耻辱感、负担）特征方面，以及对癫痫的认识方面，均无统计学差异。
高动能发作更常见于非白人患者，需要更多的照料时间。进一步的研究需要阐明 PNES 的运动表现是否可以提示其分类基础，以及是否可以指导治疗和定义预后。
