An Unusual Case of Psychogenic Non-Epileptic Seizures in the Elderly Female: A Case Report and Review of Literature

Author(s): Aseem Mehra, Sandeep Grover, Ayush Sharma

Psychogenic Non-Epileptic seizures (PNES) are classified under Functional Neurological Symptoms Disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. PNES is usually misdiagnosed as a seizure disorder in the elderly population. As a result, they keep on taking Anti-Epileptic Drugs (AED) for years before they come to know that are suffering from PNES. Apart from clinical history, Video electroencephalography (EEG) monitoring, which is the standardised approach for ruling out epilepsy, is rarely performed in every elderly patient. Even during monitoring of video-EEG, anxiety, loss of immobility can occur during the 24 hours procedure which can interfere with the results. Hence, it is important for all neurologist and psychiatrist to be sensitive enough to diagnose the PNES and to identify the psychological stressors. Early identification can prevent the undue intake of medicines and also increase the quality of life of the patient.

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