Childhood paroxysmal nonepileptic events

We aimed to determine the types and clinical characteristics of paroxysmal nonepileptic events (PNEs) in children. During a 13-year period, 765 patients underwent long-term video-EEG monitoring, and 95 (12.4%) of them were identified to have PNEs. The most common diagnoses were conversion disorder, parasomnias, staring spells, movement disorders, and hypnic jerks. Paroxysmal nonepileptic events originated from physiologic or organic (43.2%) and psychogenic (56.8%) causes. Mean delay in diagnosis was 3.1 years. Mean ages at diagnosis were 8.8 and 13.8 years in physiologic or organic and psychogenic groups, respectively. A marked female predominance was seen in the psychogenic group, whereas males slightly predominated in the physiologic or organic group. In the physiologic or organic group, events were less frequent, longer in duration, and commonly manifested as subtle motor activity, whereas subtle and prominent motor activities were encountered equally in both groups. Concomitant epilepsy was present in 10.5% of the patients. Differences in clinical characteristics may be helpful in differentiating physiologic or organic PNEs in children from psychogenic PNEs.

The gender predominance of males, a younger age at onset of symptoms, shorter duration of events, and daily seizure frequency were found as differentiating features of physiologic or organic paroxysmal nonepileptic events (PNEs) from psychogenic PNEs in children.Highlights► During a 13-year period, 765 patients underwent long-term video-EEG monitoring. ► 95 (12.4%) patients had paroxysmal nonepileptic events (PNEs). ► 56.8% of PNEs were psychogenic and the remainder were organic or physiologic in nature. ► Common diagnoses were conversion disorder, parasomnia, staring spells, and movement disorders. ► Distinctive features of organic PNEs are male predominance and short-duration event.