Mesrure KÖSEOĞLU, R.Gökçen GÖZÜBATIK-ÇELİK, Dilek ATAKLI, Muazzez Gökçen KARAHAN, Mecbure NALBANTOĞLU, Ayten CEYHAN DİRİCAN

Epilepside Non-Epileptik Nöbet Sıklığı, Anksiyete ve Depresyonla İlişkisi

Amaç: Bu çalışmada epilepsi hastalarında psikojenik-nonepileptik-nöbet (PNES) sıklığını araştırmayı; hastalığın süresi, demografik / klinik veriler ile depresyon anksiyete varlığı arasındaki ilişkiyi araştırmayı amaçladık. Yöntemler: Kesin epilepsi tanılı 108 hasta prospektif olarak çalışmaya dahil edildi. Hastalardaki PNES'lere video EEG ve hasta kayıtları değerlendirilerek tanı konuldu. Demografik özellikler, hastalık süresi, nöbet sıklığı, nöbet tipleri, tedavilerin tümü kaydedildi. Tüm hastalara Beck Depresyon ve Anksiyete Skalası uygulandı. Hastalar sadece epileptik nöbet geçirenler (Grup 1), PNES de eşlik edenler olarak iki gruba ayrıldı (Grup 2). Bulgular: Hastaların yaş ortalaması 48 ± 12.31 yıldı. Hastaların 50'sini (%51,8) kadındı. Epileptik nöbet geçiren 108 epileptik hastanın 41'inde (%37,9) PNES izlendi; 41 hastanın 25'i (%60,9) kadındı. Non-epileptik nöbet geçiren 41 hastanın 23'ünde (%56) epilepsi nöbetleri kontrol altındaydı. Depresyon ve anksiyete skorları Grup 2'de Grup 1'e göre anlamlı derecede yüksekti (p≤0.005). Tartışma: Uzun süreli ve depresif/anksiyöz semptomları olan hastalarda, özellikle farklı tipte nöbet veya tedaviye direnç varlığında nöbetler kontrol altında bile olsa PNES sorgulanmalıdır.

The Frequency of Non-Epileptic Seizures in Epileptic Patients, the Relationship with Anxiety and Depression

Objective: In this study, psychogenic-nonepileptic seizure (PNES) frequency was investigated in epileptic patients; weexplored the association between the disease duration, population / clinical data and the prevalence of depression fear.Method: The study included 108 patients with definitive epilepsy. Video EEG and medical records were treated for PNESin patients. Demographic features, duration of illness, seizure frequency, type of seizures, all treatments have beendocumented. All patients earned the Beck Depression and Anxiety Scale. Patients were divided into two groups along withepileptic (Group1) and PNES (Group2). Patients were divided into two groups.Results: The mean age of the patients was 48 ± 12.31years. Fifty-six of all patients (51.8%) were female. Psychiatricnonepileptic-seizures had been shown in 41(37.9%) of 108 epileptic patients.25 of 41 patients (60.9%) were female. Ofthe 41 patients with non-epileptic seizures, 23(56%) were observed to have epileptic seizures under control. Depressionand anxiety scores were significantly higher in Group 2 compared to Group 1 (p≤0.005).Conclusion: In patients with long-term and depressed/anxiety symptoms, PNES should be challenged, particularly in thepresence of various forms of seizures treatment resistance, even under control.

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1. Yeni SN. Epilepsi Epidemiyolojisi. Turkiye Klinikleri J Neurol-Special Topics 1. 2008: 9-16.
2. Çakıl D, İnanır S, Baykan H, et al. Epilepsi ayırıcı tanısında psikojenik non-epileptik Nöbetler. Göztepe Tıp Dergisi. 2013; 28: 41-7.
3. Fisher RS, Acevedo C, Arzimanoglou A et al. ILAE official report: a practical clinical def-inition of epilepsy. Epilepsia. 2014; 55: 475-82.
4. Akdağ G, Algın DI, Erdinç OO. Epilepsi Osmangazi Journal of Medicine. 2016; 38: 35-41.
5. Lesser, R. P. Psychogenic seizures. Neurology, 1996; 46: 1499-507.
6. Bradley WG, Daroff RB, Fenichel GM, et al. Neurology in clinical practice (principles of diagnosis and manage¬ment) 4th ed. Phledelphia 2004: 1971-2.
7. Reuber M, Qurishi A, Bauer J, et al. Are there physical risk factors for psychogenic non-epileptic seizures in patients with epilepsy? Seizure. 2003; 12: 561–7.
8. Benbadis SR, Agrawal V, Tatum WO. How many patients with psychogenic nonepileptic seizures also have epilepsy? Neurology. 2001; 57: 915–7.
9. Martin R, Burneo JG, Prasad A, et al. Frequency of epilepsy in patients with psychogenic seizures monitored by video EEG. Neurology. 2003; 61: 1791–2.
10. Chen-Block S, Abou-Khalil BW, Arain A, et al. Video-EEG results and clinical charac-teristics in patients with psychogenic nonepileptic spells: the effect of a coexistent epilepsy. Epilepsy Behav. 2016; 62: 62–5.
11. El-Naggar H, Moloney P, Widdess-Walsh P, et al. Simultaneous occurrence of nonepileptic and epileptic seizures during a single period of inpatient video-electroencephalographic monitoring. Epilepsia Open. 2017; 2: 467–71.
12. Robbins NM,Larimer P, Bourgeois JA et al. Number of patient-reported allergies helps distinguish epilepsy from psychogenic non-epileptic spells (pseudoseizures). Epilepsy Behav. 2016; 55: 174–7.
13. Benbadis SR, Allen Hauser W. An estimate of the prevalence of psychogenic non-epileptic seizures. Seizure. 2000; 9: 280-1.
14. LaFrance WC, Alosco ML, Davis JD, et al. Impact of family functioning on quality of life in patients with psychogenic nonepileptic seizures versus epilepsy. Epilepsia. 2011; 52: 292-300.
15. MarcTesta S, Lesser RP, Krauss GL, et al. Personality Assessment Inventory among pa-tients with psychogenic sei¬zures and those with epilepsy. Epilepsia. 2011; 52: 84-8.
16. Myers L, Trobliger R, Bortnik K, et al. Psychological trauma, somatization, dissociation, and psychiatric comorbidities in patients with psychogenic nonepileptic seizures compared with those in patients with intractable partial epilepsy. Epilepsy & Behavior. 2019; 108-13.
17. Neze H, Havle N, Inem C, Yener F. Epilepsi Tanısı ile Takip Edilen Kişilerde Psikiyatrik Hastalıklar ve Bunun Yaşam Kalitesi Üzerine Etkisi New/Yeni Symposium Journal. 2009; 47: 147-54.
18. Bora S, Yeni S, Gürses N, Epilepsi. 1. Basım, Nobel Tıp Kitabevleri, İstanbul. 2008; 707-34.
19. Josephson CB, Jette N. Psychiatric comorbidities in epilepsy. Int Rev Psychiatry. 2017; 29: 409-24.
20. Genç F, Yılmaz N, Biçer GY, et al. The Diagnostic and Prognostic Value of Induction Methods in Patients with Psychogenic Nonepileptic Seizures. Epilepsi. 2013; 19: 114-20.
21. Keezer MR, Sisodiya SM, Sander JW. Comorbidities of epilepsy: current concepts and future perspectives. Lancet Neurol. 2016; 15: 106- 15.
22. Bowman ES, Markand ON. Psychodynamics and psychiatric diagnoses of pseudo-seizure subjects. Am J Psychiatry. 1996; 153: 57-63.
23. Angus-Leppan H. Diagnosing epilepsy in neurology clinics: a prospective study. Seizure. 2008; 17: 431-6.
24. Syed TU, LaFrance WC Jr, Kahriman ES, et al. Can semiology predict psychogenic nonepileptic seizures? A prospective study. Ann Neurol. 2011; 69: 997-1004.
25. Moore PM, Baker GA, McDade G, et al. Epilepsy, pseudoseizures and perceived family characteristics: a controlled study. Epilepsy Res. 1994; 18: 75-83.