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 Volume 66, Number 11, June 13, 2006
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NEUROLOGY 2006;66:1644-1647
© 2006 American Academy of Neurology

Late onset psychogenic nonepileptic attacks

Roderick Duncan, MD, PhD, Meritxell Oto, MD, Emma Martin, BSc (Hons), MSc and Anthony Pelosi, FRCPsych

From West of Scotland Regional Epilepsy Service (R.D., M.O., E.M.), Institute of Neurological Sciences, Southern General Hospital, Glasgow; and Department of Psychiatry (A.P.), Hairmyres Hospital, East Kilbride, Scotland.

Address correspondence and reprint requests to Dr. R. Duncan, Department of Neurology, Southern General Hospital, Glasgow G51 4TF, Scotland.

Objective: To investigate differences between groups of patients with early vs late onset psychogenic nonepileptic attacks (PNEA).

Methods: The authors compared patients with onset of PNEA after age 55 years (n = 26) to patients whose onset of PNEA was before age 55 years (n = 241). The authors examined sociodemographic variables, factors potentially predisposing to PNEA, clinical semiology, and medical and psychiatric background.

Results: Patients with late onset PNEA were more likely to be male (p = 0.029) (p values are quoted uncorrected for multiple comparisons). They were less likely to report antecedent sexual abuse (p = 0.008), and more likely to have severe physical health problems (p < 0.001) and to report health-related traumatic experiences (p < 0.0001). There were no clear differences in PNEA clinical semiology. There was a trend to better baseline mental health in the late onset group.

Conclusions: The data suggest a distinct subgroup of patients with late onset psychogenic nonepileptic attacks, in whom psychological trauma related to poor physical health plays a prominent role.

Editorial, see page 1620

See also pages 1727 and 1730

Disclosure: The authors report no conflicts of interest.

Received November 9, 2005. Accepted in final form April 3, 2006.


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W. C. LaFrance Jr and S. R. Benbadis
Avoiding the costs of unrecognized psychological nonepileptic seizures
Neurology, June 13, 2006; 66(11): 1620 - 1621.
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