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

• Published in: Epilepsy & behavior 2021-04, Vol.117, p.107852-107852, Article 107852
• Main Authors: Valente, Kette D., Alessi, Rudá, Baroni, Gislaine, Marin, Rachel, dos Santos, Bernardo, Palmini, André
• Format: Article
• Language: English
• Subjects: Acute stress disorder; Adult; Anxiety; COVID-19; Cross-Sectional Studies; Depression; Disease Outbreaks; Electroencephalography; Female; Functional seizures; Humans; Male; Psychogenic nonepileptic seizures; Psychophysiologic Disorders - epidemiology; SARS-CoV-2; Seizures - epidemiology
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2021.107852

•Knowledge about the impact of the COVID-19 pandemic in patients with PNES is scarce.•In patients with documented PNES, 28% had worsening during the pandemic.•Higher levels of anxiety and depressive symptoms were associated factors.•After regression, stress was the strongest predictor of seizure worsening. We aimed to assess frequency of functional seizures or psychogenic nonepileptic seizures (PNES) during the COVID-19 outbreak and to recognize possible factors associated with worsening in this population. In this cross-sectional study conducted during the second phase of the pandemic, adult patients with PNES documented by video-EEG and followed up 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). 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