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Factors that should arouse suspicion of a diagnosis of psychogenic nonepileptic seizures (PNES)

Factors that should arouse suspicion of a diagnosis of psychogenic nonepileptic seizures (PNES)
Factors that should arouse suspicion of a diagnosis of PNES:
All patients:
  • Events frequent from onset
  • Multiple events per day, especially if patient appears well
  • Long (>5 minutes) events
  • Serial events
  • Swoon type event lasting >2 minutes
  • Situational triggering of events
  • Multiple events in medical situations
  • Events on emerging from anaesthetic
  • Events with onset in pregnancy
  • Symptoms suggesting hyperventilation
In patients with a diagnosis of epilepsy:
  • No response to multiple ASMs
  • Unexplained exacerbation of seizures
  • Exacerbation of seizures when a new ASM is introduced
ASM: antiseizure medication.
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