Clinical differences between patients with nonepileptic seizures who report antecedent sexual abuse and those who do not
Article first published online: 10 APR 2008
© 2008 International League Against Epilepsy
Volume 49, Issue 8, pages 1446–1450, August 2008
How to Cite
Selkirk, M., Duncan, R., Oto, M. and Pelosi, A. (2008), Clinical differences between patients with nonepileptic seizures who report antecedent sexual abuse and those who do not. Epilepsia, 49: 1446–1450. doi: 10.1111/j.1528-1167.2008.01611.x
- Issue published online: 28 JUL 2008
- Article first published online: 10 APR 2008
- Accepted March 7, 2008; Online Early publication April 10, 2008.
- Nonepileptic spells;
- Nonepileptic event disorder;
- Sexual abuse
Purpose: To investigate clinical differences between patients with psychogenic nonepileptic seizures (PNES) who report antecedent sexual abuse, and patients who do not.
Methods: In a consecutive series of 176 patients with video-EEG confirmed PNES without epilepsy, we compared patients who reported antecedent sexual abuse with those who did not report sexual abuse, in respect of a range of demographic and clinical variables.
Results: Fifty-nine women (45%) and 5 men (11%) reported sexual abuse. Those reporting sexual abuse had earlier onset PNES (28.5 vs. 33.1 years, p = 0.0319) and greater delay from onset to diagnosis (median 5.2 vs. 3.2 years, p < 0.0137). They more often drew social security benefits (p = 0.0054) and were less often in cohabiting relationships (p = 0.0006). Those who reported sexual abuse had poorer mental health on a range of indicators. Their spells were more often “convulsive” (p = 0.0419), were more severe (p = 0.0011), were more likely to have emotional triggers (p = 0.0045) and to include prodromes (p = 0.0424) and flashbacks (p < 0.0001). A history of nocturnal spells (p = 0.0109), injury during spells (p = 0.0056), and incontinence during spells (p = 0.0083) were also more common in the patients reporting sexual abuse.
Discussion: Our results suggest that patients with PNES who report sexual abuse have more severe PNES, are more likely to have PNES with features that suggest epilepsy, and are psychiatrically more unwell than those who do not report sexual abuse.