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

•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 wor...

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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
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container_title Epilepsy & behavior
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creator Valente, Kette D.
Alessi, Rudá
Baroni, Gislaine
Marin, Rachel
dos Santos, Bernardo
Palmini, André
description •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 
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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 &lt; 0.001) and NDDI-E (p &lt; 0.001) were associated with PNES worsening. There was strong evidence of a correlation between higher stress levels (p &lt; 0.001) and poor sleep quality (p 0.005) with PNES aggravation. After regression, stress was the strongest predictor of PNES increased frequency. Patients with functional neurological disorders are vulnerable during ubiquitously felt stressors. However, the atmosphere of uncertainty did not affect these patients equally. Patients with PNES showing symptoms of anxiety and depression are at higher risk of seizure worsening. 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source ScienceDirect Freedom Collection 2022-2024
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
title The COVID-19 outbreak and PNES: The impact of a ubiquitously felt stressor
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