A European questionnaire survey on epilepsy monitoring units' current practice for postoperative psychogenic nonepileptic seizures' detection.


Journal

Epilepsy & behavior : E&B
ISSN: 1525-5069
Titre abrégé: Epilepsy Behav
Pays: United States
ID NLM: 100892858

Informations de publication

Date de publication:
11 2020
Historique:
received: 25 06 2020
revised: 16 07 2020
accepted: 16 07 2020
pubmed: 4 8 2020
medline: 15 4 2021
entrez: 4 8 2020
Statut: ppublish

Résumé

In cases undergoing epilepsy surgery, postoperative psychogenic nonepileptic seizures (PNES) may be underdiagnosed complicating the assessment of postsurgical seizures' outcome and the clinical management. We conducted a survey to investigate the current practices in the European epilepsy monitoring units (EMUs) and the data that EMUs could provide to retrospectively detect cases with postoperative PNES and to assess the feasibility of a subsequent postoperative PNES research project for cases with postoperative PNES. We developed and distributed a questionnaire survey to 57 EMUs. Questions addressed the number of patients undergoing epilepsy surgery, the performance of systematic preoperative and postoperative psychiatric evaluation, the recording of sexual or other abuse, the follow-up period of patients undergoing epilepsy surgery, the performance of video-electroencephalogram (EEG) and postoperative psychiatric assessment in suspected postoperative cases with PNES, the existence of electronic databases to allow extraction of cases with postoperative PNES, the data that these bases could provide, and EMUs' interest to participate in a retrospective postoperative PNES project. Twenty EMUs completed the questionnaire sheet. The number of patients operated every year/per center is 26.7 ( ± 19.1), and systematic preoperative and postoperative psychiatric evaluation is performed in 75% and 50% of the EMUs accordingly. Sexual or other abuse is systematically recorded in one-third of the centers, and the mean follow-up period after epilepsy surgery is 10.5 ± 7.5 years. In suspected postoperative PNES, video-EEG is performed in 85% and psychiatric assessment in 95% of the centers. An electronic database to allow extraction of patients with PNES after epilepsy surgery is used in 75% of the EMUs, and all EMUs that sent the sheet completed expressed their interest to participate in a retrospective postoperative PNES project. Postoperative PNES is an underestimated and not well-studied entity. This is a European survey to assess the type of data that the EMUs surgical cohorts could provide to retrospectively detect postoperative PNES. In cases with suspected PNES, most EMUs perform video-EEG and psychiatric assessment, and most EMUs use an electronic database to allow extraction of patients developing PNES.

Sections du résumé

BACKGROUND
In cases undergoing epilepsy surgery, postoperative psychogenic nonepileptic seizures (PNES) may be underdiagnosed complicating the assessment of postsurgical seizures' outcome and the clinical management. We conducted a survey to investigate the current practices in the European epilepsy monitoring units (EMUs) and the data that EMUs could provide to retrospectively detect cases with postoperative PNES and to assess the feasibility of a subsequent postoperative PNES research project for cases with postoperative PNES.
METHODS
We developed and distributed a questionnaire survey to 57 EMUs. Questions addressed the number of patients undergoing epilepsy surgery, the performance of systematic preoperative and postoperative psychiatric evaluation, the recording of sexual or other abuse, the follow-up period of patients undergoing epilepsy surgery, the performance of video-electroencephalogram (EEG) and postoperative psychiatric assessment in suspected postoperative cases with PNES, the existence of electronic databases to allow extraction of cases with postoperative PNES, the data that these bases could provide, and EMUs' interest to participate in a retrospective postoperative PNES project.
RESULTS
Twenty EMUs completed the questionnaire sheet. The number of patients operated every year/per center is 26.7 ( ± 19.1), and systematic preoperative and postoperative psychiatric evaluation is performed in 75% and 50% of the EMUs accordingly. Sexual or other abuse is systematically recorded in one-third of the centers, and the mean follow-up period after epilepsy surgery is 10.5 ± 7.5 years. In suspected postoperative PNES, video-EEG is performed in 85% and psychiatric assessment in 95% of the centers. An electronic database to allow extraction of patients with PNES after epilepsy surgery is used in 75% of the EMUs, and all EMUs that sent the sheet completed expressed their interest to participate in a retrospective postoperative PNES project.
CONCLUSION
Postoperative PNES is an underestimated and not well-studied entity. This is a European survey to assess the type of data that the EMUs surgical cohorts could provide to retrospectively detect postoperative PNES. In cases with suspected PNES, most EMUs perform video-EEG and psychiatric assessment, and most EMUs use an electronic database to allow extraction of patients developing PNES.

Identifiants

pubmed: 32745960
pii: S1525-5050(20)30534-5
doi: 10.1016/j.yebeh.2020.107355
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

107355

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None of the authors has any conflict of interest to disclose.

Auteurs

Sofia Markoula (S)

Department of Neurology, University Hospital of Ioannina, Ioannina, Greece.

Andreas Liampas (A)

Department of Neurology, University Hospital of Ioannina, Ioannina, Greece. Electronic address: liampasand@gmail.com.

Guido Rubboli (G)

Adult Department, Danish Epilepsy Center, Epilepsihospitalet, Dianalund, Denmark.

John Duncan (J)

UCL Queen Square Institute of Neurology, Department of Clinical and Experimental Epilepsy, London, United Kingdom.

Demetrios N Velis (DN)

Department of Neurology, Department of Clinical Neurophysiology and MEG, VU University Medical Center, Amsterdam, Netherlands.

Andreas Schulze-Bonhage (A)

Epilepsy Center, University Medical Center, Freiburg, Germany.

Alla Guekht (A)

Moscow Research and Clinical Center for Neuriopsychiatry, Russian National Research Medical University, Moscow, Russia.

Karen Bartholomeyczik (K)

Epilepsy Center, University Medical Center, Freiburg, Germany.

Jane de Tisi (J)

UCL Queen Square Institute of Neurology, Department of Clinical and Experimental Epilepsy, London, United Kingdom.

Adrien Gras (A)

Psychiatry Department, Strasbourg University Hospital, Strasbourg, France.

Morten Ingvar Lossius (MI)

National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway.

Flavio Villani (F)

Division of Clinical Epileptology and Experimental Neurophysiology, "Carlo Besta" Neurological Institute Foundation, Milan, Italy.

Anke Maren Staack (AM)

Oberärztin Station Gastaut/IME, Epilepsiezentrum, Kork, Germany.

Annette Hospes (A)

Department of Neurology, Department of Clinical Neurophysiology and MEG, VU University Medical Center, Amsterdam, Netherlands.

Johannes C Baaijen (JC)

Department of Neurology, Department of Clinical Neurophysiology and MEG, VU University Medical Center, Amsterdam, Netherlands.

Elisabeth C W van Straaten (ECW)

Department of Neurology, Department of Clinical Neurophysiology and MEG, VU University Medical Center, Amsterdam, Netherlands.

Hanneke E Ronner (HE)

Department of Neurology, Department of Clinical Neurophysiology and MEG, VU University Medical Center, Amsterdam, Netherlands.

Sara Casciato (S)

Epilepsy Surgery Centre, IRCCS NEUROMED, Pozzilli, Italy.

Alfredo D'Aniello (A)

Epilepsy Surgery Centre, IRCCS NEUROMED, Pozzilli, Italy.

Addolorata Mascia (A)

Epilepsy Surgery Centre, IRCCS NEUROMED, Pozzilli, Italy.

Susana Ferrao Santos (SF)

Refractory Epilepsy Centre at Cliniquesuniversitaires Saint-Luc, University Hospital, Brussels, Belgium.

Carla Bentes (C)

EEG/Sleep Laboratory, Department of Neurosciences, Hospital de Santa Maria - CHLN, University Hospital, Lisbon, Portugal.

Ángel Aledo-Serrano (Á)

Department of Neurology, Hospital Ruber Internacional & Hospital La Luz, Madrid, Spain.

Antonio Gil-Nagel (A)

Department of Neurology, Hospital Ruber Internacional & Hospital La Luz, Madrid, Spain.

Petia Dimova (P)

Epilepsy Surgery Center, Department of Neurosurgery, St. Ivan Rilski University Hospital, Sofia, Bulgaria.

Hrvoje Hećimović (H)

Epilepsy Center, Department of Neurology, University Hospital, Zagreb, Croatia.

Çiğdem Özkara (Ç)

Department of Neurology, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey.

Kristina Malmgren (K)

Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Gothenburg University, Göteborg, Sweden.

Savvas Papacostas (S)

Department of Neurology Clinic B, The Cyprus Institute of Neurology & Genetics, Cyprus School of Molecular Medicine, Nicosia, Cyprus.

Anna Kelemen (A)

National Institute of Psychiatry and Neurology, Department of Neurology, University of Pécs, Budapest, Hungary.

Markus Reuber (M)

Academic Neurology Unit, Royal Hallamshire Hospital, University of Sheffield, Sheffield, United Kingdom.

Eugen Trinka (E)

Paracelsus Medical University Salzburg, Department of Neurology, Christian Doppler University Hospital, Salzburg, Austria.

Philippe Ryvlin (P)

Department of Clinical Neurosciences, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.

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