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Are psychogenic non-epileptic seizures just another symptom of conversion disorder?
  1. Richard A A Kanaan1,2,
  2. Roderick Duncan3,
  3. Laura H Goldstein2,
  4. Joseph Jankovic4,
  5. Andrea E Cavanna5,6,7
  1. 1 Department of Psychiatry, Austin Health, University of Melbourne, Heidelberg, Victoria, Australia
  2. 2 Departments of Psychology and Neuroscience, King’s College London, Institute of Psychiatry, London, UK
  3. 3 Department of Neurology, University of Otago, Christchurch, New Zealand
  4. 4 Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
  5. 5 Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust and University of Birmingham, Birmingham, UK
  6. 6 School of Life and Health Sciences, Aston University, Birmingham, UK
  7. 7 Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, London, UK
  1. Correspondence to Professor Richard AA Kanaan, Department of Psychiatry, LTB10, Austin Health, 145 Studley Road, Heidelberg VIC 3084, Australia; richard.kanaan{at}unimelb.edu.au

Abstract

Background Psychogenic non-epileptic seizures (PNES) are classified with other functional neurological symptoms as ‘Conversion Disorder’, but there are reasons to wonder whether this symptomatology constitutes a distinct entity.

Methods We reviewed the literature comparing PNES with other functional neurological symptoms.

Results We find eight studies that directly examined this question. Though all but one found significant differences—notably in presenting age, trauma history, and dissociation—they were divided on whether these differences represented an important distinction.

Conclusion We argue that the aetiological and mechanistic distinctions they support, particularly when bolstered by additional data, give reason to sustain a separation between these conditions.

  • functional neurological disorder
  • aetiology
  • mechanism
  • nosology
  • psychogenic movement disorder

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Footnotes

  • Contributor RAAK and AEC designed the study, collected the data and act as guarantors. All authors wrote the manuscript, had full access to all of the data in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding This paper represents independent research part-funded (LHG) by the National Institute for Health Research (NIHR) Dementia Biomedical Research Unit at South London and Maudsley NHS Foundation Trust and King’s College London.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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