ABSTRACT
OBJECTIVE: The goal of this article was to describe the clinical characteristics and outcomes of patients diagnosed with psychogenic nonepileptic seizures (PNES). METHODS: We conducted a retrospective review of patients diagnosed with PNES in a 5-year period. RESULTS: Fifty patients with PNES were identified, giving an estimated incidence of 0.91/100,000 per annum. Thirty-eight were included for review, 15 of whom were male (39%). Eighteen patients had been diagnosed with epilepsy as well as PNES (47%). We demonstrated a gender difference in our patients, with males having higher seizure frequencies, more antiepileptic drug use, and a longer interval before diagnosis of PNES. Females were diagnosed with other conversion disorders more often than males. Impaired social function was observed in PNES, as was resistance to psychological interventions with a subsequent poor response to treatments. CONCLUSIONS: PNES remains a difficult condition to treat, and may affect males in proportions higher than those described in previous studies.
Subject(s)
Anticonvulsants/therapeutic use , Cost of Illness , Psychophysiologic Disorders/diagnosis , Seizures/therapy , Adult , Conversion Disorder/complications , Conversion Disorder/diagnosis , Conversion Disorder/psychology , Electroencephalography , Female , Humans , Male , Mental Disorders/complications , Mental Disorders/diagnosis , Mental Disorders/psychology , Middle Aged , Psychophysiologic Disorders/complications , Psychophysiologic Disorders/psychology , Retrospective Studies , Seizures/etiology , Seizures/psychology , Severity of Illness Index , Sex Factors , Statistics, Nonparametric , Treatment OutcomeABSTRACT
We describe a patient with the diagnoses of acquired neuromyotonia, cutaneous lupus erythematosus and alopecia areata, occurring many years after a thymectomy for myasthenia gravis associated with a thymoma. We review the current literature on autoimmune conditions associated with myasthenia gravis and thymectomy. To our knowledge, this combination of multiple autoimmune conditions has not been reported previously.
