Biomarkers in the diagnosis and study of psychogenic nonepileptic seizures: A systematic review

Seizure : the Journal of the British Epilepsy Association
T SundararajanX F Jimenez

Abstract

Video electroencephalography (vEEG) is the gold-standard method for diagnosing psychogenic nonepileptic seizures (PNES), but such assessment is expensive, unavailable in many centers, requires prolonged hospitalization, and many times is unable to capture an actual seizure episode. This paper systematically reviews other non-vEEG candidate biomarkers that may facilitate both diagnosis and study of PNES as differentiated from epileptic seizures (ES). PubMed database was searched to identify articles between 1980 and 2015 (inclusion: adult PNES population with or without controls, English language; exclusion: review articles, meta-analyses, single case reports). A total of 49 studies were examined, including neuroimaging, autonomic nervous system, prolactin, other (non-prolactin) hormonal, enzyme, and miscellaneous marker studies. Functional MRI studies have shown PNES is hyperlinked with dissociation and emotional dysregulation centers in the brain, although conflicting findings are seen across studies and none used psychiatric comparators. Heart rate variability suggests increased vagal tone in PNES when compared to ES. Prolactin is elevated in ES but not PNES, although shows low diagnostic sensitivity. Postictal cortisol and c...Continue Reading

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Citations

Apr 6, 2016·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Gaetano ValenzaRiccardo Barbieri
Jun 14, 2016·Seizure : the Journal of the British Epilepsy Association·William O TatumWilliam P Cheshire
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Aug 31, 2020·Epilepsy & Behavior : E&B·Hue Mun Au YongUdaya Seneviratne
Mar 2, 2021·Journal of Child Neurology·Prateek Kumar Panda, Indar Kumar Sharawat
Apr 14, 2021·Neuroscience and Biobehavioral Reviews·Primavera A SpagnoloMark Hallett
Apr 19, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Sara A FinkelsteinJon Stone
May 22, 2021·Seizure : the Journal of the British Epilepsy Association·Gislaine BaroniAndré Palmini
Aug 27, 2018·Seizure : the Journal of the British Epilepsy Association·Alistair WardropeMarkus Reuber
Aug 6, 2018·Seizure : the Journal of the British Epilepsy Association·Leila SimaniMarjan Asadollahi

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