Mortality in patients with psychogenic non-epileptic seizures

Objective

To investigate the hypothesis that patients diagnosed with PNES on video-EEG monitoring (VEM) have increased mortality by comparison to the general population.

 

Methods

This retrospective cohort study included patients evaluated in VEM units of three tertiary hospitals in Melbourne, Australia, between January 1st, 1995 and December 31st, 2015. Diagnosis was based on consensus opinion of experienced epileptologists and neuropsychiatrists at each hospital. Mortality was determined in patients diagnosed with PNES, epilepsy or both conditions, by linkage to the Australian National Death Index (NDI). Lifetime history of psychiatric disorders in PNES was determined from formal neuropsychiatric reports. 

 

Results

5,508 patients underwent VEM. 674 (12.2%) were diagnosed with PNES, 3064 (55.6%) with epilepsy, 175 (3.2%) with both conditions, and 1,595 (29.0%) received other diagnoses or had no diagnosis made. The standardised mortality ratio (SMR) of patients d...