Evidence map›Paper›PMID 33621828›Full record

ArticleSeizure2021

Factors associated with delay to video-EEG in dissociative seizures.

Wesley T Kerr, Xingruo Zhang, Chloe E Hill, Emily A Janio, Andrea M Chau, Chelsea T Braesch, Justine M Le, Jessica M Hori, Akash B Patel, Corinne H Allas and 14 more

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Seizure, 2021. 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 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.6field-weighted citation impact, top 10% 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.

NCT07059325 early_phase1recruitingnot on this mapstarted 2025, after this paper: background citation

Accelerated, Left Prefrontal Transcranial Magnetic Stimulation for Functional Seizures; An Open-Label Exploration of Feasibility, Tolerability, and Preliminary Efficacy

TypeinterventionalSponsorMedical University of South CarolinaRan2025 to 2027Enrolled30ConditionsFunctional Neurological Symptom Disorder, Functional SeizuresArmsTranscranial Magnetic Stimulation
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 25 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Iatrogenic harm in functional neurological disorder.Brain : a journal of neurology · 2025
    Review
  7. Article
  8. Article
  9. Article
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

24 authors at 2 institutions in 1 country.

Wesley T KerrDepartment of Neurology, 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@g.UCLA.edu.
Xingruo ZhangDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
Chloe E HillDepartment of Neurology, University of Michigan, Ann Arbor, MI, United States.
Emily A JanioDepartment 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.
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.
Corinne H AllasDepartment of Neurology, 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.
Amir H KarimiDepartment of Neurology, 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.
Ishita DubeyDepartment of Neurology, 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.
Siddhika S SreenivasanDepartment of Neurology, 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.
Norma L GallardoDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Janar BauirjanDepartment of Neurology, David Geffen School of Medicine at UCLA, 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.
Shannon R D'AmbrosioDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Mona Al BannaDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
Andrew Y ChoDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
Sandra R DewarDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
Jerome EngelDepartment of Neurology, 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; Department of 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.
Jamie D FeusnerDepartment of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States.
John M SternDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
University of California, Los Angeles · USUniversity of Michigan · 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
Systems in Integrative BiologyT32GM008185 · NIGMS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI CHOU, TOM · 1987 to 2022
$4.6M
Translational Neuroscience Training GrantR25NS065723 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI CARMICHAEL, STANLEY THOMAS · 2009 to 2023
$2.8M
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
UCLA Neuroscience Physician-Scientist Training ProgramUE5NS065723 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Stanley Thomas Carmichael, Jason D Hinman · 2024 to 2026
$1.2M
NIDA NIH HHS R90 DA023422NIDA NIH HHS T90 DA022768NIGMS NIH HHS T32 GM008042NIGMS NIH HHS T32 GM008185NINDS NIH HHS P20 NS080181NINDS NIH HHS R01 NS033310NINDS NIH HHS R25 NS065723NINDS NIH HHS UE5 NS065723
6 · The paper itself

Abstract

purposeWhile certain clinical factors suggest a diagnosis of dissociative seizures (DS), otherwise known as functional or psychogenic nonepileptic seizures (PNES), ictal video-electroencephalography monitoring (VEM) is the gold standard for diagnosis. Diagnostic delays were associated with worse quality of life and more seizures, even after treatment. To understand why diagnoses were delayed, we evaluated which factors were associated with delay to VEM.

methodsUsing data from 341 consecutive patients with VEM-documented dissociative seizures, we used multivariate log-normal regression with recursive feature elimination (RFE) and multiple imputation of some missing data to evaluate which of 76 clinical factors were associated with time from first dissociative seizure to VEM.

resultsThe mean delay to VEM was 8.4 years (median 3 years, IQR 1-10 years). In the RFE multivariate model, the factors associated with longer delay to VEM included more past antiseizure medications (0.19 log-years/medication, standard error (SE) 0.05), more medications for other medical conditions (0.06 log-years/medication, SE 0.03), history of physical abuse (0.75 log-years, SE 0.27), and more seizure types (0.36 log-years/type, SE 0.11). Factors associated with shorter delay included active employment or student status (-1.05 log-years, SE 0.21) and higher seizure frequency (0.14 log-years/log[seizure/month], SE 0.06).

conclusionsPatients with greater medical and seizure complexity had longer delays. Delays in multiple domains of healthcare can be common for victims of physical abuse. Unemployed and non-student patients may have had more barriers to access VEM. These results support earlier referral of complex cases to a comprehensive epilepsy center.

Indexed as

ElectroencephalographyQuality of LifeSeizuresAdultChildHumansProspective StudiesRetrospective StudiesDiagnostic delaysFunctional seizuresHealthcare disparitiesPsychogenic nonepileptic attack disorder (PNEA, PNEAD)Psychogenic nonepileptic seizures (PNES)

Identifiers

PMID33621828
PMCPMC8006748
OpenAlexW3132514486

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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.