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Predictive Factors for Outcome of Nonepileptic Seizures After Diagnosis

Received December 22, 1998; revised April 6, 1999; accepted May 24, 1999. From the Departments of Neurology, Psychology, and Psychiatry and the Epilepsy Management Program, State University of New York at Stony Brook; and the Department of Neurology and the Comprehensive Epilepsy Center, New York University School of Medicine, Hospital for Joint Diseases Orthopaedic Institute, New York, New York. Address correspondence to Dr. Ettinger, Comprehensive Epilepsy Center, EEG Lab, Long Island Jewish Medical Center, 270–05 76th Avenue, New Hyde Park, NY 11040.

The aim of this study was to assess prognosis among adult patients with nonepileptic seizures (NES) and to determine predictor variables for resolution of NES after diagnosis. Six to 9 months after receiving a video-EEG-documented diagnosis of NES, 43 adults responded by telephone interview to a detailed, structured questionnaire probing history of the episodes, psychiatric factors, socioeconomic variables, relationships, reactions to receiving the diagnosis, and potential history of litigation. At follow-up, only 18.6% were episode-free, 55.8% had improved, 16.3% reported no change, and 9.3% reported greater frequency of episodes. Patients who reported having many friends currently or having good relationships with friends as a child were significantly more likely to be episode-free. Subjects with pending litigation were significantly less likely to experience a reduction in episodes.

Key Words: Epilepsy • Seizures • Pseudoseizures

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