Seizure semiologies of epileptic and psychogenic nonepileptic patients and neuropsychological evaluations in the preictal- early postictal period

Purpose: The aim of this study is to determine the seizure related cognitive impairments both in patients having epileptic seizures and patients having psychogenic non-epileptic attacks by using neuropsychological tests performed in pre- and postictal periods. Moreover, analyzing the semiologies of non-epileptic seizure patients who applied to the Dokuz Eylul University (DEU) Epilepsy and Sleep Disorders Center as well as determining the possible relation between certain semiological features and disruptions in cognitive tests together with the assessment of characteristic and temperament features of additional psychiatric disease comorbidities, were aimed.Method: 20 Psychogenic non-epileptic and 11 epileptic patients and 20 healthy control cases were included to our study. Cognitive test battery was applied to the cases and repeated in temporal relation with seizures. The observed seizures were analyzed in terms of 18 semiologic features. In addition, the cases in all of the groups were evaluated using the Mini Neuropsychiatric Interview (MINI), Temperament and Character Inventory (TCI) and mood scales.Findings: Spesific semiological features were determined to be more significant in patients having psychogenic non-epileptic attacks (PNEA) compared with the patients having epilepsy. In the cognitive assessments made, the impairments in the PNEA and in the epileptic groups were found out to be in different areas but no difference was observed in the repeated tests. In the PNEA group, mood scale scores were recorded to be significantly higher. Certain character and temperament features were defined in the PNEA group. In the epileptic group descriptive character features were observed.Conclusion: Joint evaluation of all the features and multidisciplinary approach are important in regard of true diagnosis and appropriate treatment in nonepileptic psychogenic seizures.