Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: A staged approach: A report from the International League Against Epilepsy Nonepileptic Seizures Task Force

W. Curt Lafrance*, Gus A. Baker, Rod Duncan, Laura H. Goldstein, Markus Reuber

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

614 Citations (Scopus)

Abstract

An international consensus group of clinician-researchers in epilepsy, neurology, neuropsychology, and neuropsychiatry collaborated with the aim of developing clear guidance on standards for the diagnosis of psychogenic nonepileptic seizures (PNES). Because the gold standard of video electroencephalography (vEEG) is not available worldwide, or for every patient, the group delineated a staged approach to PNES diagnosis. Using a consensus review of the literature, this group evaluated key diagnostic approaches. These included: history, EEG, ambulatory EEG, vEEG/monitoring, neurophysiologic, neurohumoral, neuroimaging, neuropsychological testing, hypnosis, and conversation analysis. Levels of diagnostic certainty were developed including possible, probable, clinically established, and documented diagnosis, based on the availability of history, witnessed event, and investigations, including vEEG. The aim and hope of this report is to provide greater clarity about the process and certainty of the diagnosis of PNES, with the intent to improve the care for people with epilepsy and nonepileptic seizures.

Original languageEnglish
Pages (from-to)2005-2018
Number of pages14
JournalEpilepsia
Volume54
Issue number11
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Differential diagnosis
  • Electroencephalogram
  • Epilepsy
  • Nonepileptic seizures
  • Tests
  • Video EEG monitoring

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