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To assess and synthesize information on which clinical features can help differentiate psychogenic nonepileptic seizures (PNES) from epileptic seizures (ES), researchers critically analyzed 34 video-electroencephalography (video-EEG) studies.
The authors found that the diagnosis of PNES was supported if episodes were long in duration (typically longer than 2–3 minutes); emerged from apparent sleep yet with EEG-verified wakefulness; or had a fluctuating course, asynchronous movements, pelvic thrusting, side-to-side head or body movement; or if the patient had closed eyes during the episode, ictal crying, recall of ictal events, and absence of postictal confusion. The diagnosis of ES was supported if stertorous breathing occurred after a convu…