Evidence map›Paper›PMID 28236725›Full record

ArticleEpilepsy & behavior : E&B2017

Diagnostic implications of review-of-systems questionnaires to differentiate epileptic seizures from psychogenic seizures.

Wesley T Kerr, Emily A Janio, Chelsea T Braesch, Justine M Le, Jessica M Hori, Akash B Patel, Sarah E Barritt, Norma L Gallardo, Janar Bauirjan, Andrea M Chau and 7 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsy & behavior : E&B, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 3 institutions in 1 country.

Wesley T KerrDepartment of Biomathematics, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States. Electronic address: WesleyTK@UCLA.edu.
Emily A JanioDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Chelsea T BraeschDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Justine M LeDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Jessica M HoriDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Akash B PatelDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Sarah E BarrittDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Norma L GallardoDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Janar BauirjanDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Andrea M ChauDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Eric S HwangDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Emily C DavisDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
David Torres-BarbaDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Andrew Y ChoDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Jerome EngelDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States; Departments of Neurology and Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Brain Research Institute, University of California Los Angeles, Los Angeles, CA, United States.
Mark S CohenDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States; Departments of Neurology and Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Departments of Radiology, Psychology, Biomedical Physics, and Bioengineering, University of California Los Angeles, Los Angeles, CA, United States; California NanoSystems Institute, University of California Los Angeles, Los Angeles, CA, United States.
John M SternDepartments of Neurology and Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
Neurobehavioral Systems · USUniversity of California, Los Angeles · USCalifornia NanoSystems Institute · US

Funding

UCLA-Caltech Medical Scientist Training ProgramT32GM008042 · NIGMS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI AJIJOLA, OLUJIMI A, DAWSON, DAVID WAYNE · 1985 to 2023
$29.9M
Comprehensive Training in Neuroimaging Fundamentals and ApplicationsR90DA023422 · NIDA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI COHEN, MARK STEVEN · 2006 to 2015
$1.7M
The Epilepsy Bioinformatics Study (EpiBioS)P20NS080181 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ENGEL, JEROME NONE, HOVDA, DAVID A · 2012 to 2014
$1.7M
Comprehensive Training in Neuroimaging Fundamentals and ApplicationsT90DA022768 · NIDA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI COHEN, MARK STEVEN · 2006 to 2015
$1.5M
NIDA NIH HHS R90 DA023422NIDA NIH HHS T90 DA022768NIGMS NIH HHS T32 GM008042NINDS NIH HHS P20 NS080181
6 · The paper itself

Abstract

objectiveEarly and accurate diagnosis of patients with psychogenic nonepileptic seizures (PNES) leads to appropriate treatment and improves long-term seizure prognosis. However, this is complicated by the need to record seizures to make a definitive diagnosis. Suspicion for PNES can be raised through knowledge that patients with PNES have increased somatic sensitivity and report more positive complaints on review-of-systems questionnaires (RoSQs) than patients with epileptic seizures. If the responses on the RoSQ can differentiate PNES from other seizure types, then these forms could be an early screening tool.

methodsOur dataset included all patients admitted from January 2006 to June 2016 for video-electroencephalography at UCLA. RoSQs prior to May 2015 were acquired through retrospective chart review (n=405), whereas RoSQs from subsequent patients were acquired prospectively (n=190). Controlling for sex and number of comorbidities, we used binomial regression to compare the total number of symptoms and the frequency of specific symptoms between five mutually exclusive groups of patients: epileptic seizures (ES), PNES, physiologic nonepileptic seizure-like events (PSLE), mixed PNES plus ES, and inconclusive monitoring. To determine the diagnostic utility of RoSQs to differentiate PNES only from ES only, we used multivariate logistic regression, controlling for sex and the number of medical comorbidities.

resultsOn average, patients with PNES or mixed PNES and ES reported more than twice as many symptoms than patients with isolated ES or PSLE (p<0.001). The prospective accuracy to differentiate PNES from ES was not significantly higher than naïve assumption that all patients had ES (76% vs 70%, p>0.1). DISCUSSION: This analysis of RoSQs confirms that patients with PNES with and without comorbid ES report more symptoms on a population level than patients with epilepsy or PSLE. While these differences help describe the population of patients with PNES, the consistency of RoSQ responses was neither accurate nor specific enough to be used solely as an early screening tool for PNES. Our results suggest that the RoSQ may help differentiate PNES from ES only when, based on other information, the pre-test probability of PNES is at least 50%.

Indexed as

Surveys and QuestionnairesAdultComorbidityDiagnosis, DifferentialElectroencephalographyEpilepsyFemaleHumansMalePrognosisProspective StudiesRetrospective StudiesSeizuresSomatoform DisordersComputer-diagnosticsEpilepsyPseudoseizuresReview-of-systemsScreeningVideo-electroencephalography

Identifiers

PMID28236725
PMCPMC5423814
OpenAlexW2591474998

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.