Evidence map›Paper›PMID 28895657›Full record

ArticleEpilepsia2017

Identifying psychogenic seizures through comorbidities and medication history.

Wesley T Kerr, Emily A Janio, Chelsea T Braesch, Justine M Le, Jessica M Hori, Akash B Patel, Norma L Gallardo, Janar Bauirjan, Shannon R D'Ambrosio, Andrea M Chau and 10 more

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

Article in Epilepsia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 5% 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

27 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.

  1. Pain and functional neurological disorder: a systematic review and meta-analysis.Journal of neurology, neurosurgery, and psychiatry · 2024
    Pooled it
  2. Unmet needs in functional neurological disorder related to digital healthcare.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2026
    Review
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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

20 authors at 3 institutions in 1 country.

Wesley T KerrDepartment of Internal Medicine, Eisenhower Medical Center, Rancho Mirage, California, U.S.A.ORCID 0000-0002-5546-5951
Emily A JanioDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Chelsea T BraeschDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Justine M LeDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Jessica M HoriDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Akash B PatelDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Norma L GallardoDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Janar BauirjanDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Shannon R D'AmbrosioDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Andrea M ChauDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Eric S HwangDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Emily C DavisDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Albert BuchardDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
David Torres-BarbaDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Mona Al BannaDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Sarah E BarrittDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Andrew Y ChoDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Jerome EngelDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
Mark S CohenDepartment of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, U.S.A.
John M SternDepartments of Neurology and Neurobiology, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
University of California, Los Angeles · USCalifornia NanoSystems Institute · USEisenhower Medical Center · 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
IN VIVO STUDIES OF THE EPILEPTIC HIPPOCAMPUSR01NS033310 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JEROME NONE ENGEL, Richard Staba · 1994 to 2026
$7.5M
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 NS080181NINDS NIH HHS R01 NS033310
6 · The paper itself

Abstract

objectiveLow-cost evidence-based tools are needed to facilitate the early identification of patients with possible psychogenic nonepileptic seizures (PNES). Prior to accurate diagnosis, patients with PNES do not receive interventions that address the cause of their seizures and therefore incur high medical costs and disability due to an uncontrolled seizure disorder. Both seizures and comorbidities may contribute to this high cost.

methodsBased on data from 1,365 adult patients with video-electroencephalography-confirmed diagnoses from a single center, we used logistic and Poisson regression to compare the total number of comorbidities, number of medications, and presence of specific comorbidities in five mutually exclusive groups of diagnoses: epileptic seizures (ES) only, PNES only, mixed PNES and ES, physiologic nonepileptic seizurelike events, and inconclusive monitoring. To determine the diagnostic utility of comorbid diagnoses and medication history to differentiate PNES only from ES only, we used multivariate logistic regression, controlling for sex and age, trained using a retrospective database and validated using a prospective database.

resultsOur model differentiated PNES only from ES only with a prospective accuracy of 78% (95% confidence interval =72-84%) and area under the curve of 79%. With a few exceptions, the number of comorbidities and medications was more predictive than a specific comorbidity. Comorbidities associated with PNES were asthma, chronic pain, and migraines (p < 0.01). Comorbidities associated with ES were diabetes mellitus and nonmetastatic neoplasm (p < 0.01). The population-level analysis suggested that patients with mixed PNES and ES may be a population distinct from patients with either condition alone. SIGNIFICANCE: An accurate patient-reported medical history and medication history can be useful when screening for possible PNES. Our prospectively validated and objective score may assist in the interpretation of the medication and medical history in the context of the seizure description and history.

Indexed as

AdultComorbidityElectroencephalographyFemaleHumansMaleMedication ReconciliationMiddle AgedProspective StudiesRetrospective StudiesSeizuresSomatoform DisordersVideo RecordingAsthmaMachine learningMigrainesPsychogenic nonepileptic attack disorderScreening

Identifiers

PMID28895657
PMCPMC5669805
OpenAlexW2756330815

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.