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Spectral power changes prior to psychogenic non-epileptic seizures: a pilot study
  1. Anne Marthe Meppelink1,2,
  2. Isabel Pareés1,3,
  3. Martijn Beudel1,2,
  4. Simon Little1,
  5. Mahinda Yogarajah4,
  6. Sanjay Sisodiya5,
  7. Mark J Edwards4
  1. 1 Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, UK
  2. 2 Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
  3. 3 Department of Neurology, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
  4. 4 Department of Cell Sciences, St George's University, London, UK
  5. 5 Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
  1. Correspondence to Dr Anne Marthe Meppelink, Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, Groningen 9700 VB, The Netherlands; a.m.meppelink{at}umcg.nl

https://doi.org/10.1136/jnnp-2016-314080

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    Introduction

    Psychogenic non-epileptic seizures (PNES) are the most common manifestation of functional (psychogenic) neurological symptoms. Clinically, they consist of intermittent episodes that resemble epileptic seizures and can involve changes in behaviour, movement, sensation, autonomic function or consciousness. To date, there are no positive EEG features that have been identified that are diagnostic of PNES and therefore, the diagnosis is primarily based on clinical assessment and the absence of epileptic activity during the seizure.

    Our goal was to identify a positive marker of PNES, by assessing EEG spectral power changes prior to non-epileptic attacks.

    We hypothesised that decreases in β power (desynchronisation in the 13–30 Hz band) might occur prior to a non-epileptic seizure. β-Desynchronisation is known to occur prior to cued movement (event-related desynchronisation, ERD) or self-paced movement and was recently shown to occur prior to functional myoclonic jerks.1

    Methods

    Participants

    We recruited three patients previously diagnosed with PNES from the Movement Disorder outpatient clinics at the National Hospital for Neurology and Neurosurgery. Three EEG recordings of patients with convulsive epileptic attacks were used as control. The study was approved by the local Ethics Committee and informed consent was obtained.

    Procedure

    Patients were seated in a comfortable chair while a 32-channel EEG was recorded and a video was made. We asked each participant to sit in a relaxed position with their eyes open and to let attacks happen in their usual way …

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    Footnotes

    • Contributors AMM, IP and MJE designed the study, AMM and IP conducted the study. AMM, MB and SL performed the analyses. AMM wrote the first draft, which was reviewed by all coauthors. AMM is the guarantor and accepts full responsibility for the work and/or the conduct of the study, had access to the data and controlled the decision to publish.

    • Funding Institutional (Sobell Department of Motor Neuroscience and Movement Disorders, University College London, UCL).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval UCL.

    • Provenance and peer review Not commissioned; externally peer reviewed.