Gender differences in psychogenic non-epileptic seizures

Purpose: To determine whether male and female populations of patients with psychogenic non-epileptic seizures (PNES) are similar, in terms of demographic and social factors, aetiological factors, the clinical characteristics of events and path to diagnosis. Methods: Prospective study by semi-structured interview of 160 consecutive patients (117 female and 43 male) with video EEG confirmed diagnosis of PNES + epileptic seizures (ES). Results: Most parameters showed no significant differences. Males were, however, more likely to be unemployed (P=0.028), and females were six times more likely to self-harm (P=0.050), though the numbers were small in these categories. Men were more likely to attribute their PNES to a predisposing factor for epilepsy (P=0.001), and women were over eight times more likely to report sexual abuse (P=0.001). Event semiology was similar, but women were more likely to weep after events (P=0.017). The carers and family of men with PNES were three times less likely to accept the diagnosis of PNES (P=0.017). Conclusions: Our samples showed few significant gender differences, suggesting that other male and female populations of patients with PNES are likely to be similar also. Some of the differences we found may give insight into causation of PNES.