Retrospective investigation of the factors affecting the short and LONG-TERM prognoses of patients diagnosed with NON-epileptic psychogenic seizure in video EEG monitorization unit

Psychogenic non-epileptic seizures (PNES) are paroxysmal episodes with subjective or objective symptoms that resemble epileptic seizures but do not show abnormal epileptiform activity. Video EEG monitoring (VEM) is the gold standard method for the diagnosis of PNES. Despite all psychotropic drugs and psychotherapeutic treatment methods, the prognosis of PNES is generally poor. The aim of our study is to examine the short and long-term outcomes of patients with PNES diagnosed by VEM and the potential factors affecting these outcomes. Patients diagnosed with PNES in the VEM Unit of Uludag University Faculty of Medicine Neurology Department between January 2010 and June 2020 were included in our study. The short-term (6 months after discharge) and longterm (last 1-year) results of the patients were evaluated. In addition, the patients were divided into two groups as pure PNES and mixed seizures according to whether epilepsy accompanied or not, and their clinical and demographic characteristics were also examined. Only 6.9% of patients were seizure-free in short-term follow-up. In the short term; while diagnosis in patients within 1 year, advanced age of onset and having a seizure duration longer than 5 minutes are associated with good prognosis; having an additional psychiatric disease, having problems in the family, having subjective seizures, prolonging the duration of the disease, and increasing the number of psychiatric drugs used were associated with poor prognosis. In the long-term follow-up, only 37.7% of the patients were seizure-free. In the long term; while the patients being working or student at the time of diagnosis and having a seizure duration longer than 5 minutes are associated with good prognosis; the patient's female gender, being abused or neglected as a child, and having family problems were associated with poor prognosis. As a result; the prognosis of PNES is poor. Knowing the prognosis of the disease and the affecting factors can help determine the treatments to be applied to the patients.