Table of Contents
Epilepsy Research and Treatment
Volume 2011 (2011), Article ID 274736, 7 pages
http://dx.doi.org/10.1155/2011/274736
Review Article

Prognosis and Outcome Predictors in Psychogenic Nonepileptic Seizures

1Department of Neuropsychiatry, BSMHFT and University of Birmingham, Barberry Building, 25 Vincent Drive, Birmingham B152FG, UK
2Department of Neuropsychiatry, UCL Institute of Neurology, London WC1N 3BG, UK

Received 27 October 2010; Accepted 11 January 2011

Academic Editor: Luigi Maria Specchio

Copyright © 2011 Joseph Durrant et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

It is estimated that one in five patients referred to specialist epilepsy clinics for refractory seizures have psychogenic nonepileptic seizures (PNES). Despite the high prevalence, little is known about the prognosis of patients with PNES. In this paper we set out to systematically assess published original studies on the prognosis and outcome predictors of patients with PNES. Our literature search across the databases Medline, PsycINFO, and EMBASE generated 18 original studies meeting the search criteria. Prognosis was found to be poor in adults, but good in children. Predictors of poor outcome included the presence of coexisting epilepsy or psychiatric comorbidities, violent seizure phenomenology, dependent lifestyle, and poor relationships. Overall, too much reliance is placed on seizure remission as an outcome measurement for patients with PNES, and the impact of many of the outcome predictors requires evaluation using larger studies with longer followup.