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Of the patients seen in epilepsy centers, 10% to 40% are diagnosed with psychogenic nonepileptic seizures (PNES). According to clinical lore, many if not most patients with PNES also have genuine seizures. To better understand the nature of seizures in these patients, physicians from an Australian tertiary epilepsy center examined records of 221 consecutively admitted PNES patients.
An average of 5.6 years passed after first presentation before the true diagnosis was made; 64% of patients also had psychiatric diagnoses recorded (depression, 48%; anxiety, 15%; substance use, 12%). Only 8% had strictly defined, concurrent, genuine epilepsy (another 10% had probable epilepsy). Of all PNES patients, 63% were being treated with antiepileptic medi…