“Review of systems" Questionnaire as a Predictive Tool for Psychogenic Non-Epileptic Seizures. (S14.005)
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OBJECTIVE: Determine if a routine review of system (ROS) questionnaire may serve as a predictive tool for psychogenic non-epileptic seizures. BACKGROUND: Psychogenic non-epileptic seizures (PNES) represent a subset of pharmaco-resistant epilepsy. PNES is often misdiagnosed as epileptic seizures (ES) leading to unnecessary and potentially harmful treatment. Certain characteristics have been described that increase the likelihood for PNES including ictal stuttering and the "teddy bear sign", which are specific, but not sensitive, markers. We observed that patients clinically suspected to have PNES tend to report more somatic complaints in our ROS. DESIGN/METHODS: A retrospective analysis of standardized ROS questionnaire completed by patients with definite PNES and ES diagnosis. A multivariate analysis of covariance was used to determine whether PNES and ES groups differed. Ten-fold cross-validation was used to evaluate the predictive error of a logistic regression classifier for PNES status based on percentage of positive complaints. RESULTS: A total of 44 patients were included. PNES and ES groups were similar with respect to gender, age at evaluation, psychiatric history, and history of abuse. Compared to the ES group, the PNES group had a significantly later age of epilepsy onset. From MANCOVA, PNES patients were found to have a larger percentage of positive complaints on ROS than epilepsy patients (F=20.78, p<0.0001). With a cutoff of 17[percnt] of the ROS items reported as positive, there is 78.3[percnt] specificity and 85.7[percnt] sensitivity of the diagnosis being PNES, with higher specificity of diagnosis at higher cutoffs. CONCLUSIONS: Our study demonstrates that multiple somatic complaints in a standard review of system questionnaire exhibits great sensitivity and specificity for the diagnosis of PNES, and may be a useful aid in developing a pretest probability for its diagnosis during evaluation of seizures. A prospective study is underway to validate our current findings. Study Supported by: No support.Keywords:
Psychogenic disease
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Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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Psychogenic disease
Abnormality
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Psychogenic disease
Medical record
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Psychogenic disease
Semiology
Concomitant
Medical History
Seizure types
Epilepsy syndromes
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The aim of this study was to evaluate the frequency of epilepsy in patients who presented psychogenic non-epileptic seizures (PNES). The evaluation was carried out during intensive VEEG monitoring in a diagnostic center for epilepsy in a university hospital. The difficulties involved in reaching this diagnosis are discussed. Ninety-eight patients underwent intensive and prolonged video-electroencephalographic (VEEG) monitoring; out of these, a total of 28 patients presented PNES during monitoring. Epilepsy was defined as present when the patient presented epileptic seizures during VEEG monitoring or when, although not presenting epileptic seizures during monitoring, the patient presented unequivocal interictal epileptiform discharges. The frequency of epilepsy in patients with PNES was 50% (14 patients). Our findings suggest that the frequency of epilepsy in patients with PNES is much higher than that of previous studies, and point out the need, at least in some cases, for prolonging the evaluation of patients with PNES who have clinical histories indicating epilepsy.
Psychogenic disease
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Abstract Background: Epilepsy is one of the most common neurological diseases. The coexistence of epilepsy and PNES poses a major challenge to neurologists and psychiatrists in the treatment and follow-up care of patients. Methods: 33 Sudanese patients with epilepsy and concomitant psychogenic non epileptic seizure where included in this study and full detailed history of both epilepsy and PNES was obtained. The study was conducted in Daoud charity clinic during the period from May to July 2018 Results : Out of 33 patients 19 were males and 14 were females. Seven patients had focal epilepsy, 23 had generalized tonic clonic epilepsy (GTC), 2 had GTC with atypical absent seizure, and one had GTC with myoclonus.Six patients experienced an attack of PNES after more than 1 year of being free of epilepsy, while 9 patients had PNES attack between 3 months to 1 year of the last attack of epilepsy, and 18 patients developed both PNES and epilepsy within less than 3 months.The pattern of presentation of PNES was bizarre movements in 13 patients, abnormal behavior in 9 patients, while 11 patients experienced both bizarre movement and abnormal behavior note that all those 11 patients had GTC epilepsy. Conclusion: Experiencing psychogenic non epileptic seizure (PNES) in patients with coexisting PNES and epilepsy is not affected by the epilepsy free period
Psychogenic disease
Generalized epilepsy
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