Epilepsy

Adult Epilepsy: Effect of Therapy on Psychogenic Nonepileptic Seizure

Treatment of Patients With PNES

2019 – 2021

A total of 337 patients with psychogenic nonepileptic seizures (PNES) were treated with cognitive behavioral therapy (CBT) between 2019 and 2021, during which they had at least 1 CBT session in 2021.

Of these 337 patients, 28 had at least 2 visits with PHQ-9 data at both pre- and post-CBT treatment. Among patients with a PHQ-9 of 10 or higher (N = 14), 78.6% improved, 21.4% remained stable, and 0% worsened. Clinically meaningful change was defined as a total point change of ≥ 5 points. Median time between PHQ-9 completions was 287 days (range, 72-753).

28 PNES patients treated with CBT had at least 2 visits with PROMIS-10 Physical Health data available for analysis. Among those patients whose baseline PROMIS-10 Physical Health score ≤ 45 (N = 24), 33.3% (N = 8) showed improvement, 58.3% (N = 14) remained stable, and 8.3% (N = 2) worsened. Median duration of follow-up was 280 days (range, 87-988).

28 PNES patients treated with CBT had at least 2 visits with PROMIS-10 Mental Health data available for analysis. Among those patients whose baseline PROMIS-10 Mental Health score ≤ 45 (N = 22), 40.9% (N = 9) showed improvement, 50% (N = 11) remained stable, and 9.1% (N = 2) worsened. Median duration of follow up was 322 days (range, 87-1002).

References
  1. LaFrance WC Jr, Baird GL, Barry JJ, Blum AS, Frank Webb A, et al; NES Treatment Trial (NEST-T) Consortium. Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial. JAMA Psychiatry. 2014 Sep;71(9):997-1005.