Post-Traumatic Psychogenic Seizure and Epilepsy Project
Technical Report,30 Sep 2017,29 Sep 2018
VA Connecticut Research and Education West Haven United States
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Over 80,000 veterans who utilize the VA healthcare system are diagnosed with epilepsy, and preliminary data suggest a substantial proportion actually suffer from Psychogenic Non-Epileptic Seizures PNES instead, a psychiatric disorder. In the DSM-V, PNES is classified as a conversion disorder, a type of somatic symptom disorder diagnosed as such after appropriate medical assessment finds the presenting neurological symptoms incompatible with neurological pathophysiology. In this case, individuals with PNES display seizure-like events without a vEEG correlate and can exhibit characteristic semiology distinct from epileptic seizures. Known risk factors for developing PNES in the general population include mental, physical, and social distress. Among veterans, a history of post-traumatic stress disorder PTSD and traumatic brain injury TBI are associated with PNES however, the complex relationship between these three disorders is not well understood. The main objective of this study is to establish the role of PTSD, TBI, and other co-morbidities chronic pain, military sexual trauma, female gender in the causal pathway of PNES among post-911 veterans. Secondary objectives are to study the relationship between the treatment psychotropic and psychotherapeutic of PTSD, mood, and other anxiety disorders and the risk of developing PNES, the severity of the disorder number of monthly psychogenic seizures, and likelihood of recovery seizure free for six months. This is a longitudinal retrospective cohort study of veterans who utilized the VA healthcare system for at least two years during the period of 2002-2015. We have grouped them into those who meet criteria for epilepsy n 6811, PNES n 327 as defined by the International League Against Epilepsy, and a comparison group n 1.2 million who have no documented epilepsy or PNES history.
- Medicine and Medical Research