Non-epileptic psychogenic seizures: semiology in a patient’s cohort from a national reference epilepsy unit in Lima, Peru

Abstract

Objective: To describe the semiology of Psychogenic Non-Epileptic Seizures (PNES) in patients diagnosed by video-electroencephalogram (VEEG) in a national epilepsy center. Methods: An observational, descriptive, and retrospective study of patients older than 14 years, admitted for telemetry monitoring at the Epilepsy Unit of the National Hospital Edgardo Rebagliati Martins in Lima, Peru, between January 1^st, 2017, and December 31, 2022. A definitive diagnosis of PNES was reached through VEEG. Results: Twenty of 26 studied patients were female and 6 male. Most patients experienced loss of posture with falls (92%), gradual onset (88%), some degree of altered consciousness or responsiveness during the event (73%). The most prevalent motor signs included asynchronous movements of the trunk and/or extremities (73%), fluctuation in motor activity (73%), global or limb tremors (54%), and forced eyelid closure (50%). Non-motor signs were predominantly subjective symptoms (34%). Most of the patients presented motor PNES (73%) compared to non-motor (12%) and mixed (15%). Conclusions: The described clinical events had a prolonged duration, gradual onset, and altered levels of consciousness/responsiveness. The most frequent clinical motor signs were asynchronous movements of the trunk and/or extremities, motor fluctuation, tremors, and forced eyelid closure. Non-motor findings were, primarily, subjective symptoms. Most of the patients presented motor PNES.