The COVID-19 outbreak and PNES: The impact of a ubiquitously felt stressor.

Abstract Objective We aimed to assess frequency of functional seizures or psychogenic non-epileptic seizures (PNES) during the COVID-19 outbreak and to recognize possible factors associated with worsening in this population. Methods In this cross-sectional study conducted during the second phase of the pandemic, adult patients with PNES documented by video-EEG and followed in two tertiary epilepsy centers responded to a structured telephone survey. Data were gathered on demographics, clinical features and frequency of PNES, history of psychiatric comorbidity, access to treatment, as well as on anxiety (GAD-7 items) and depressive symptoms (NDDI-E). Results Fifty-four patients (78% female; mean age of 31.36 years [SD = 10.6]) were contacted and 15 (28%) reported increased frequency of PNES during the pandemic. Higher scores of GAD-7 items (p Significance Patients with functional neurological disorders are vulnerable during ubiquitously felt stressors. However, the atmosphere of uncertainty did not affect these patients equally. Patients with PNES showing symptoms of anxiety and depression are at higher risk for worsening. Early identification of this subset of patients may prevent this detrimental outcome.