Differential semiology based on VEEG monitoring between psychogenic non-epileptic seizures and temporal lobe epileptic seizures

Abstract Introduction Psychogenic non-epileptic seizures (PNES) are disruptive changes in behavior without ictal correlate of epileptic activity and high prevalence of psychiatric morbidity. Differential diagnosis is difficult particularly with TLE (temporal lobe epilepsy), which is also associated with high prevalence of psychiatric comorbidity. Although Video-EEG (VEEG) is the gold standard for differential diagnosis, clinical semiology analysis may help the clinician in general medical practice. In this study the differential semiology based on VEEG, between PNES and TLE seizures was analysed. Methods The VEEG of patients with diagnosis of PNES and TLE were reviewed and compared between groups. Clinical semiology of all episodes recorded by VEEG in each patient was analyzed and classified according to the presence of: behavioral arrest, motor hyperkinetic activity, impaired awareness, aura and automatisms. Chi square test and binary logistic regression were determined. Results Thirty-two patients with PNES (32 ±11 years) and 34 with TLE (32 ±12 years) were included. Female patients were predominant in PNES group (p Conclusion Clinical semiology analysis may orientate the differential diagnosis in general medical practice, between PNES and TLE seizures. Further studies comparing PNES semiology with other subtypes of epilepsies may complete these preliminary findings.