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Psychogenic nonepileptic seizures (PNES; sometimes also called pseudoseizures) are a common and significant clinical problem, leading to ineffective treatment and potential anticonvulsant toxicity. Clinical diagnosis is difficult and expensive, and the gold-standard technique is monitoring in an epilepsy unit. To explore whether ictal eye closure is a reliable indicator of PNES, these researchers retrospectively reviewed video-EEG data from 234 consecutive patients (938 ictal events) at an inpatient monitoring unit.
Fifty-two patients had PNES (24% of 221 evaluable patients; 73% female), 50 of whom consistently closed their eyes during their seizures. Of the 156 patients with epileptic seizures (49% female), 152 had their eyes wide open or d…