Abstract Details

Psychogenic Non-Epileptic Seizures (PNES) are not commonly diagnosed in the elderly and have relatively few published studies. Continuous video-electroencephalography (cVEEG) with clinical correlation is used to differentiate epileptic from non-epileptic events.

To determine the prevalence and characteristics of older adults aged 65 and above who were diagnosed with PNES and underwent cVEEG monitoring at a community hospital in western North Carolina.

Characterization of studied population

Between January 1, 2019 and August 31, 2021, a total of 1001 cVEEG studies were performed. We excluded 92 studies on patients with therapeutic hypothermia and 299 studies on critically ill patients.  We analyzed the results of 609 studies on 549 patients. There were 294 females (53.5%) and 255 males (46.5%), aged between 65-101 years, mean 76.35 years, SD 7.58. Sixty patients had multiple studies.

Characterization of studied factors

Long-term cVEEG studies extended on average for 30.39 hours, SD 19.37, range 6-160 hours. PNES was diagnosed in 18 out of 549 patients (3.3%). There were three males and fifteen females. The average age was 77 years, ranging between 65-95 years. Ten patients had anxiety, six had depression, five had history of trauma, including sexual abuse. Other diagnoses included substance abuse, bipolar disorder, and cognitive impairment. Eight patients had concomitant epilepsy.

PNES should be considered in the diagnosis of paroxysmal spells in older adults to provide social and psychological support while avoiding unnecessary anticonvulsants.