Prevalence and risk factors of psychogenic non-epileptic seizures (PNES) among adult Sudanese epileptic patients who attend Dauod charity clinic, Sudan, 2021

Background: Seizures can present in many diseases like epilepsy which is in the list of the commonest neurological diseases. Some seizures can present as psychogenic seizures. Epilepsy can also be associated with psychogenic non-epileptic seizures.Objectives: To assess prevalence and risk factors of psychogenic non-epileptic among adult Sudanese epileptic patients.Methodology: A descriptive cross-sectional facility-based study was conducted during Jan-Feb 2021 at Daoud Charity Clinic in Omdurman city, Sudan. Data collection was conducted through an interview-based structured questionnaire and there was a total number of 99 participants who were included in this study. Results: Overall, in this study there were 99 epileptic patients. 57% were females, 79% of the patients reside in Khartoum, and 32% reached secondary school. The main type of epilepsy was generalized tonic clonic (68%) followed by focal with impairment (11%). The majority of patients have been diagnosed with epilepsy for more than three years (65%). Psychogenic non-epileptic seizures history was found in 29 (29%). The PNES prevalence was significantly higher in patients with social problems and depression (p value 0.005, 0.00 respectively). Patients with depression were having 14 times risk to have psychogenic non-epileptic seizures than patients without depression (CI 95%: ##-##). Most of the participants had no sexual or physical abuse history, school/university/work refusal, and\or absence (94%, 84%, and 63% respectively).Conclusion: A considerable high prevalence rate of PNES can be found among adult epileptic patients. Epileptic patients suffering from social problems or/and depression and poor economic status have a higher tendency to develop psychogenic non-epileptic seizures especially after two to three years of treatment and above.

The relation of fibromyalgia and fibromyalgia symptoms to self-reported seizures

Objective Several epidemiological and clinical reports associate fibromyalgia (FM) with seizure disorders, and clinical studies associate FM diagnosis with psychogenic non-epileptic seizures. However, these associations rely on self-reports of being diagnosed with FM or unstandardized clinical diagnosis in combination with small samples. We investigated the association of FM and self-reported seizures using a large rheumatic disease databank and the current established self-reported, symptom-based FM diagnostic criteria. Methods We selected a random observation from 11,378 subjects with rheumatoid arthritis (RA), 2,390 (21.0%) of whom satisfied 2016 revised criteria for FM. Patients were inquired about the presence of any kind of seizures in the previous 6 months, anti-epileptic medications, and patient-reported symptoms and outcomes. Results Seizures were reported by 89 RA patients who met FM criteria (FM+) and by 97 patients who did not (FM-), resulting in an age- and sex-adjusted seizure prevalence of 3.74 (95% CI 2.95 to 4.53) per 100 FM+ subjects and 1.08 (95% CI 0.87 to 1.30) in FM- subjects. The seizure odds ratio of FM+ to FM- cases was 3.54 (95% CI 2.65 to 4.74). Seizures were associated to a very similar degree with symptom reporting (somatic symptom count and comorbidity index) as to FM diagnosis variables. RA patients reporting seizures also reported worse pain, quality of life, and functional status. Seizure patients treated with anti-seizure medication had worse outcomes and more comorbidities than seizure patients with no seizure drugs. Conclusions We found a significant and similar association of both FM diagnostic variables and FM-related symptom variables, including the number of symptoms and comorbidities, with self-reported seizures in people with RA. The observed association was similar to those found in previous studies of symptoms variables and seizures and does not suggest a unique role for fibromyalgia diagnosis. Rather, it suggests that multi-symptom comorbidity is linked to seizures in a complex and not yet clearly understood way. As the current study relied on self-reported seizures and was not able to distinguish between epileptic and psychogenic nonepileptic seizures, future studies are needed to replicate the findings using both validated FM criteria assessments and clinically verified diagnoses of epileptic and psychogenic seizures.