ArticleSeizure2016
Diagnostic delay in psychogenic seizures and the association with anti-seizure medication trials.
Article in Seizure, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07059325 (Accelerated, Left Prefrontal Transcranial Magnetic Stimulation for Functional Seizures; An Open-Label Exploration of Feasibility, Tolerability, and Preliminary Efficacy), which is not on this map. Cited by 43 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Accelerated, Left Prefrontal Transcranial Magnetic Stimulation for Functional Seizures; An Open-Label Exploration of Feasibility, Tolerability, and Preliminary Efficacy
Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- A systematic review of brain stimulation in functional seizures.BMC neurology · 2026Pooled it
- Automated seizure detection with noninvasive wearable devices: A systematic review and meta-analysis.Epilepsia · 2022Pooled it
- Trial
- Article
- Quantifying the impact of a computer-aided diagnostic score on the clinical diagnosis of functional seizures.Epilepsia · 2026Article
- Proposed criteria of levels of evidence for co-occurring epilepsy in people with functional/dissociative seizures.Epilepsia · 2026Article
- Using Genetics to Shed Light on the Scientific Gray Zone of Functional Seizures.Biological psychiatry global open science · 2026Article
- Pregnancy outcomes and changes to seizure frequency during pregnancy for patients with functional seizures.Epilepsy & behavior : E&B · 2025Article
- Use of an Electronic Medical Record Alert to Prevent Iatrogenic Interventions in Patients With Psychogenic Nonepileptic Seizures.Neurology. Clinical practice · 2025Article
- Can artificial intelligence diagnose seizures based on patients' descriptions? A study of GPT-4.Epilepsia · 2025Article
- Supervised machine learning compared to large language models for identifying functional seizures from medical records.Epilepsia · 2025Article
- Referral to a Functional Seizures Clinic Reduces Inpatient and Emergency Department Health Care Utilization and Costs.Neurology. Clinical practice · 2025Article
- Iatrogenic harm in functional neurological disorder.Brain : a journal of neurology · 2025Review
- Epilepsy Therapies Symposium | Do We Really "Outgrow" Seizures?Epilepsy currents · 2024Review
- Sexual Abuse, Post-Traumatic Stress Disorder and Psychopathological Characteristics in Women with Functional/Dissociative Seizures.Actas espanolas de psiquiatria · 2024Article
- Elevated Mortality Rate in Patients With Functional Seizures After Diagnosis and Referral.Neurology. Clinical practice · 2024Article
- Dissociative seizures in the emergency room: room for improvement.Journal of neurology, neurosurgery, and psychiatry · 2024Article
- Functional neurological disorder is a feminist issue.Journal of neurology, neurosurgery, and psychiatry · 2023Review
- The Financial Burden of Functional Neurological Disorders.Current neurology and neuroscience reports · 2023Review
- Psychogenic Nonepileptic Seizures-High Mortality Rate Is a 'Wake-Up Call'.Journal of personalized medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 2 institutions in 1 country.
Funding
Abstract
purposeThe average delay from first seizure to diagnosis of psychogenic non-epileptic seizures (PNES) is over 7 years. The reason for this delay is not well understood. We hypothesized that a perceived decrease in seizure frequency after starting an anti-seizure medication (ASM) may contribute to longer delays, but the frequency of such a response has not been well established.
methodsTime from onset to diagnosis, medication history and associated seizure frequency was acquired from the medical records of 297 consecutive patients with PNES diagnosed using video-electroencephalographic monitoring. Exponential regression was used to model the effect of medication trials and response on diagnostic delay.
resultsMean diagnostic delay was 8.4 years (min 1 day, max 52 years). The robust average diagnostic delay was 2.8 years (95% CI: 2.2-3.5 years) based on an exponential model as 10 to the mean of log10 delay. Each ASM trial increased the robust average delay exponentially by at least one third of a year (Wald t=3.6, p=0.004). Response to ASM trials did not significantly change diagnostic delay (Wald t=-0.9, p=0.38).
conclusionAlthough a response to ASMs was observed commonly in these patients with PNES, the presence of a response was not associated with longer time until definitive diagnosis. Instead, the number of ASMs tried was associated with a longer delay until diagnosis, suggesting that ASM trials were continued despite lack of response. These data support the guideline that patients with seizures should be referred to epilepsy care centers after failure of two medication trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.