Long-term outcome in a sample of underprivileged patients with psychogenic nonepileptic seizures (PNES) living in Argentina

Abstract

Objective: The objective of the present study was to perform a long-term follow-up of economicallydisadvantaged Latin American patients diagnosed as having psychogenic nonepileptic seizures (PNES) andcontribute to the field´s understanding of outcome in this population.Background: A handful of studies have examined outcome of patients once the diagnosis of PNES has beencommunicated. However, the vast majority of these have been conducted in the first world countries withsamples that were predominantly Caucasian. There is limited knowledge about outcome in economicallydisadvantaged Latin American patients diagnosed as having PNES.Methods: This is a study of 23 patients (20women, 3men)with PNES inwhich demographic data (age, education,nationality, presence of psychological trauma, age of onset) were retrospectively retrieved from medical files.Follow-up was done through a telephonic questionnaire in which investigators collected clinical information(seizure characteristics at follow-up, and treatments employed) and changes in demographic data.Results: Patients fromthis Argentinian PNES sample demonstrated havingmany similar demographic and clinicalcharacteristics to samples from US and European studies. Long-term follow-up revealed, however, decreasedseizure frequency and intensity as well as a substantial improvement in occupational status. A majority hadengaged in psychotherapy aswell as alternative and complementary approaches. Amajority had also developedwhat are suspected to be other functional symptoms.Conclusions: Argentinian patients from economically disadvantaged backgrounds, diagnosed as having PNESreported improvements in seizure frequency and occupational status during long-termfollow-up. Future studieswill need to focus on what (e.g., communication of diagnosis, psychotherapy, alternative treatments) may havecontributed to these changes.