Risk Factors for Diagnostic Delay in Psychogenic Nonepileptic Seizures Among Children and Adolescents.

BACKGROUND

This study aims to analyze a series of pediatric patients with psychogenic nonepileptic seizures (PNES) to establish the diagnostic gap and possible risk factors for the delayed diagnosis in this age group.

METHODS

We evaluated all children with PNES documented by video electroencephalography. None had a previous diagnosis of PNES. In total, we included 53 children (interquartile range: seven to 17 years; mean age 12.81 years [S.D. 3.15]; 60.4% girls) who underwent a protocol consisting of neurological and psychiatric interviews.

RESULTS

The average time between seizure onset and referral was 17.76 months (interquartile range: 0.5 to 48 months; S.D. ± 12.62). Earlier age of onset correlated with a later diagnosis (P < 0.001). The late referral group also presented with a history of psychological abuse (P = 0.018).

CONCLUSION

Youth with PNES represent a diagnostic challenge. Identification of children at risk might lead to earlier diagnosis of PNES.