Late Breaking News
PNES Diagnosis Previously Delayed in Veterans
- Categorized in: 2013 Compendium of Federal Medicine
A 2011 study found that psychogenic non-epileptic seizures (PNES) went undiagnosed for much longer in veterans compared to civilians.
The delay, according to the authors, was associated with greater, cumulative antiepileptic drug (AED) treatment, according to the authors from the Portland, OR, VAMC.
“Psychogenic nonepileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) and can result in significant long-term disability,” according to the study published in the journal Neurology. “We reviewed our experience with veterans undergoing seizure evaluation in the EMU to determine the time delay to diagnosis of PNES, the frequency of PNES, and cumulative antiepileptic drug (AED) treatment. We compared veterans with PNES to civilians with PNES studied in the same EMU.”
For the study, researchers reviewed records of 203 veterans and 726 civilians from a university affiliate admitted to one VAMC EMU over a 10-year interval, calculating the percentage of patients with PNES in each group. The two groups were compared for interval from onset of the habitual spells to EMU diagnosis, cumulative AED treatment, and other measures.
While PNES were identified in 25% of veterans and 26% of civilians admitted to the EMU, the delay from onset of spells to EMU diagnosis averaged 60.5 months for veterans compared to only 12.5 months for civilians.
On the other hand, cumulative AED treatment was four times greater for veterans with PNES as compared to civilians, according to the authors, who noted that 58% of veterans with PNES were thought to have seizures related to traumatic brain injury.
Study authors noted that 18 of the 50 veterans with non-epileptic seizures were from areas where an epilepsy monitoring unit was not available, but that issue has been addressed by the creation of the VA Epilepsy Centers of Excellence.
1 Salinsky M, Spencer D, Boudreau E, Ferguson F. Psychogenic nonepileptic seizures in US veterans. Neurology. 2011 Sep 6;77(10):945-50. doi: 10.1212/WNL.0b013e31822cfc46. PubMed PMID: 21893668.
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