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[PUBLICATION] Differentiating PNES from epileptic seizures using conversational analysis on French patients

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Differentiating PNES from epileptic seizures using conversational analysis on French patients: A prospective blinded study
Differentiating PNES from epileptic seizures using conversational analysis on French patients: A prospective blinded study
Date(s)

le 10 août 2020

Published in Epilepsy Behav

Collaborative research project led by Prof. Caroline Duwicquet (Department of Neurology, University Hospital of Tours, France) in which Prof. Wissam El-Hage and Prof. Bertrand de Toffol participated

Differentiating PNES from epileptic seizures using conversational analysis on French patients: A prospective blinded study

Abstract

Psychogenic nonepileptic seizures (PNES) resemble epileptic seizures (ES) but are not caused by the occurrence of excessive cortical neuronal discharge. Previous studies in German-, English-, and Italian-speaking patients showed that patients used a different communicative style to talk about their seizures. They demonstrated that the diagnosis between PNES and ES could be predicted using qualitative assessment and a diagnostic scoring aid (DSA). The objective of our study was to evaluate the contribution of linguistic analysis in the differential diagnosis between ES and PNES in a French patient population. During an extended video-electroencephalogram (video-EEG) monitoring, 13 patients presented PNES and 19 patients with ES. Two neurologists blindly and independently analyzed the interview of each patient. Rater 1 predicted the correct diagnosis in 27 of 32 patients (84%) and Rater 2 in 28 of 32 patients (88%). Interrater reliability of qualitative analysis was satisfactory (k = 0.68, interrater agreement = 84.4%). Using a simplified DSA, Rater 1 and Rater 2 would have correctly diagnosed 88% (28/32 patients) and 91 % (29/32) of the cases, respectively. Our blinded prospective study confirms the diagnostic value of conversational analysis, performed by neurologists, to differentiate PNES from ES in French-speaking patients.

Keywords

Conversational analysis; Epilepsy; Psychogenic nonepileptic seizures; Video-EEG monitoring.

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