MRI findings in patients with psychogenic non‐epileptic seizures: Prevalence, distribution, and classification of the findings. A single tertiary epilepsy center experience

Abstract Objective Psychogenic non‐epileptic seizures (PNES) mimic epileptic seizures without electroencephalographic correlation. Although classified as psychiatric disorders, their neurobiological or structural basis remains unclear. This study aimed to assess the prevalence and characteristics of...

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Main Authors: Aleix Jareno‐Badenas, Mario Matute‐González, Luis Pintor, Estefanía Conde‐Blanco, Mar Carreño, Xavier Setoain, Camilo Pineda, Fernando Diego Choque‐Chávez, Tomás Fernández, Núria Bargalló, Sofía González‐Ortiz
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Epilepsia Open
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Online Access:https://doi.org/10.1002/epi4.13114
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author Aleix Jareno‐Badenas
Mario Matute‐González
Luis Pintor
Estefanía Conde‐Blanco
Mar Carreño
Xavier Setoain
Camilo Pineda
Fernando Diego Choque‐Chávez
Tomás Fernández
Núria Bargalló
Sofía González‐Ortiz
author_facet Aleix Jareno‐Badenas
Mario Matute‐González
Luis Pintor
Estefanía Conde‐Blanco
Mar Carreño
Xavier Setoain
Camilo Pineda
Fernando Diego Choque‐Chávez
Tomás Fernández
Núria Bargalló
Sofía González‐Ortiz
author_sort Aleix Jareno‐Badenas
collection DOAJ
description Abstract Objective Psychogenic non‐epileptic seizures (PNES) mimic epileptic seizures without electroencephalographic correlation. Although classified as psychiatric disorders, their neurobiological or structural basis remains unclear. This study aimed to assess the prevalence and characteristics of MRI abnormalities in patients with PNES and those with comorbid epilepsy, compared to the general population, to enhance radiological evaluation and management. Method We retrospectively identified patients with a definitive diagnosis of PNES, evaluated in the refractory epilepsy unit of our tertiary epilepsy center. Patients were classified into two groups according to their comorbidity with epilepsy (PNES and PNES+). The MRI findings were evaluated and classified by two radiologists, who reported the category of the findings, laterality, and location. The two groups were compared using the chi‐square test, as well as the frequencies of findings in the general population extracted from the literature. Results Forty‐six patients fulfilled the inclusion criteria. Thirty females and 16 males. MRI findings were present in 25/35 (71.4%) patients in the PNES group and 9/11 (81.8%) In the PNES + group, showing statistically significant differences in the frequency of findings with the general population (8.4–28.1%). Significance MRI anomalies are common in PNES patients and even more prevalent in complex cases referred to epilepsy units, underscoring the necessity of correlating MRI findings with clinical‐electrical patterns. Plain Language Summary In this article, we observed a higher frequency of cerebral magnetic resonance findings in patients with psychogenic non‐epileptic seizures than in the general population. We also observed a higher frequency of this pathology among women, as well as right cerebral hemisphere affections. The exposed findings suggest a potential structural basis of this pathology. This hypothesis requires confirmation with larger studies.
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spelling doaj-art-94fe0846a0cd4510a1743d51226d3f8d2025-02-07T09:12:45ZengWileyEpilepsia Open2470-92392025-02-0110126927610.1002/epi4.13114MRI findings in patients with psychogenic non‐epileptic seizures: Prevalence, distribution, and classification of the findings. A single tertiary epilepsy center experienceAleix Jareno‐Badenas0Mario Matute‐González1Luis Pintor2Estefanía Conde‐Blanco3Mar Carreño4Xavier Setoain5Camilo Pineda6Fernando Diego Choque‐Chávez7Tomás Fernández8Núria Bargalló9Sofía González‐Ortiz10Radiology Department Hospital Clinic of Barcelona Barcelona SpainRadiology Department Hospital Clinic of Barcelona Barcelona SpainPsychiatry Department Hospital Clinic of Barcelona Barcelona SpainNeurology Department Hospital Clinic of Barcelona Barcelona SpainNeurology Department Hospital Clinic of Barcelona Barcelona SpainNuclear Medicine Department Hospital Clinic of Barcelona Barcelona SpainRadiology Department Hospital Clinic of Barcelona Barcelona SpainRadiology Department Hospital Clinic of Barcelona Barcelona SpainRadiology Department Hospital Clinic of Barcelona Barcelona SpainRadiology Department Hospital Clinic of Barcelona Barcelona SpainRadiology Department Hospital Clinic of Barcelona Barcelona SpainAbstract Objective Psychogenic non‐epileptic seizures (PNES) mimic epileptic seizures without electroencephalographic correlation. Although classified as psychiatric disorders, their neurobiological or structural basis remains unclear. This study aimed to assess the prevalence and characteristics of MRI abnormalities in patients with PNES and those with comorbid epilepsy, compared to the general population, to enhance radiological evaluation and management. Method We retrospectively identified patients with a definitive diagnosis of PNES, evaluated in the refractory epilepsy unit of our tertiary epilepsy center. Patients were classified into two groups according to their comorbidity with epilepsy (PNES and PNES+). The MRI findings were evaluated and classified by two radiologists, who reported the category of the findings, laterality, and location. The two groups were compared using the chi‐square test, as well as the frequencies of findings in the general population extracted from the literature. Results Forty‐six patients fulfilled the inclusion criteria. Thirty females and 16 males. MRI findings were present in 25/35 (71.4%) patients in the PNES group and 9/11 (81.8%) In the PNES + group, showing statistically significant differences in the frequency of findings with the general population (8.4–28.1%). Significance MRI anomalies are common in PNES patients and even more prevalent in complex cases referred to epilepsy units, underscoring the necessity of correlating MRI findings with clinical‐electrical patterns. Plain Language Summary In this article, we observed a higher frequency of cerebral magnetic resonance findings in patients with psychogenic non‐epileptic seizures than in the general population. We also observed a higher frequency of this pathology among women, as well as right cerebral hemisphere affections. The exposed findings suggest a potential structural basis of this pathology. This hypothesis requires confirmation with larger studies.https://doi.org/10.1002/epi4.13114dissociationmagnetic resonance imaging (MRI)neuroimagingpsychogenic non‐epileptic seizures (PNES)
spellingShingle Aleix Jareno‐Badenas
Mario Matute‐González
Luis Pintor
Estefanía Conde‐Blanco
Mar Carreño
Xavier Setoain
Camilo Pineda
Fernando Diego Choque‐Chávez
Tomás Fernández
Núria Bargalló
Sofía González‐Ortiz
MRI findings in patients with psychogenic non‐epileptic seizures: Prevalence, distribution, and classification of the findings. A single tertiary epilepsy center experience
Epilepsia Open
dissociation
magnetic resonance imaging (MRI)
neuroimaging
psychogenic non‐epileptic seizures (PNES)
title MRI findings in patients with psychogenic non‐epileptic seizures: Prevalence, distribution, and classification of the findings. A single tertiary epilepsy center experience
title_full MRI findings in patients with psychogenic non‐epileptic seizures: Prevalence, distribution, and classification of the findings. A single tertiary epilepsy center experience
title_fullStr MRI findings in patients with psychogenic non‐epileptic seizures: Prevalence, distribution, and classification of the findings. A single tertiary epilepsy center experience
title_full_unstemmed MRI findings in patients with psychogenic non‐epileptic seizures: Prevalence, distribution, and classification of the findings. A single tertiary epilepsy center experience
title_short MRI findings in patients with psychogenic non‐epileptic seizures: Prevalence, distribution, and classification of the findings. A single tertiary epilepsy center experience
title_sort mri findings in patients with psychogenic non epileptic seizures prevalence distribution and classification of the findings a single tertiary epilepsy center experience
topic dissociation
magnetic resonance imaging (MRI)
neuroimaging
psychogenic non‐epileptic seizures (PNES)
url https://doi.org/10.1002/epi4.13114
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